Effects of the COVID-19 pandemic on lifestyle among Iranian population: A multicenter cross-sectional study.

Background: Quarantine, an unpleasant experience, was implemented in many countries to limit the spread of Coronavirus disease 2019 (COVID-19), which it could associated whit lifestyle changes. The present study aimed to determine the changes in Iranian's lifestyle during COVID-19 pandemic. Materials and Methods: In the present cross-sectional study, 2710 Iranian people completed an online researcher-made questionnaire asking lifestyle regarding COVID-19, which includes five sections about physical activity, stress and anxiety, nutrition habit, sleep disorders, and interpersonal relationship in addition to demographic data from January to February 2021, using the multistage cluster sampling method. Results: The participants' mean age was 33.78 ± 11.50 years and 68.3% of them were female. Traveling, sightseeing, and family visits have been eliminated from 91%, 83.5%, and 77.5% of participants' lives, respectively. There were increase in stress level (P < 0.001), weight of the participants (P < 0.001), sleep problems (P < 0.001), and healthier foods (P < 0.001) but decrease in interpersonal communication (P < 0.001) and the amount of physical activity (P < 0.001). Conclusion: In summary, this study indicates some changes in lifestyle of Iranian people, including changes in some eating practices, physical activity, social communication, and sleeping habits during the pandemic. However, as the COVID-19 pandemic is ongoing, a comprehensive understanding of these behaviors and habits can help develop interventions to mitigate the negative lifestyle behaviors during COVID-19 pandemic.

Myocardial infarction in a neonate with severe hypertrophic cardiomyopathy: a case report.

Hypertrophic cardiomyopathy (HCM) is a rare and heterogeneous disorder in newborns, which can predispose them to other cardiac conditions such as myocardial infarction (MI). This case report describes the clinical presentation of a premature infant born at 30 weeks of gestation, who developed cardiac failure due to myocardial ischemia. The newborn exhibited distal acrocyanosis and respiratory distress shortly after birth. Echocardiography revealed significant left ventricular hypercontractility and hypertrophy, along with moderate pericardial effusion, tricuspid regurgitation and mitral regurgitation. Despite treatment with furosemide and inotropes, the patient's condition deteriorated, leading to demise after 14 days. Early detection of MI in newborns with vascular complications and HCM plays a crucial role in their management. In conclusion, the coexistence of acute MI and hypertrophic cardiomyopathy may be indicative of a fatal outcome. Hypertrophic cardiomyopathy (HCM) is a rare and heterogeneous disorder in newborns, which can predispose them to other cardiac conditions such as MI. This case report describes the clinical presentation of a premature infant born at 30 weeks of gestation, who developed cardiac failure due to myocardial ischemia. The newborn exhibited distal acrocyanosis and respiratory distress after birth. Echocardiography revealed significant left ventricular hypercontractility, moderate pericardial effusion, tricuspid regurgitation and mitral regurgitation. Despite treatment, the patient's condition deteriorated, leading to demise after 14 days. Early detection of MI in newborns with vascular complications and HCM plays a crucial role in their management. In conclusion, the coexistence of acute MI and hypertrophic cardiomyopathy may be indicative of a fatal outcome.

Comparing the Effect of Music and Puzzle-Solving on Anxiety Before Surgery in Children: A Randomized Clinical Trial.

OBJECTIVE: Hospitalization and the possibility of surgery are known as the main causes of anxiety in children, and anxiety is a natural physiological process in individuals that allows them to adapt and deal with a diversity of adverse conditions. The purpose of this research aimed to compare 2 methods of distraction including puzzle-solving and music on anxiety before pediatric surgery. MATERIALS AND METHODS: This study is clinical trial research. First, 90 children 6 to 10 years old were randomly assigned to the intervention and control groups. In group A, the visual puzzlesolving items were presented, in group B, music with related pictures via a tablet was presented in the waiting room for surgery, and in group C, only standard care for each patient was presented. Anxiety before surgery was measured with a Children's Fear Scale questionnaire before moving the patient to the operating room, then 30 minutes before surgery in the pre-surgery waiting room, and the third stage immediately after transfer to the operating room before induction of anesthesia. Data were analyzed by one-way analysis of variance, chi-square test, and Tukey test using Statistical Package for the Social Sciences software version 21.0. RESULTS: The results of this research showed that the levels of anxiety significantly improved in the intervention groups compared to the control group after the intervention (P < .001). CONCLUSION: Music and puzzle-solving as complementary therapy can improve the levels of anxiety in children before surgery. Therefore, this technique can be recommended to be used along with modern medicine in children.

Does moral sensitivity contribute to patient satisfaction? A cross-sectional survey in educational hospitals.

Introduction: Our study aims to assess interactions between the moral sensitivity of physicians and the satisfaction of patients. Methods: This is a cross-sectional study. Data were collected by a standard questionnaire of the physicians' moral sensitivity about decision-making and a researcher-made patient satisfaction questionnaire. The physicians were selected through the census method, and patients were selected using quota sampling to equal the selection of each physician from each work shift. All information was analyzed by SPSS statistical software version 23. Results: The mean score for physicians' moral sensitivity was 91.6 ± 0.63 which shows a high level of moral sensitivity. The average patient satisfaction was 61.97 ± 3.55 out of the total score (23-115) which shows a moderate level of satisfaction with the highest scores in the domain of "professionalism" and the lowest scores were related to the domain of "Technical Quality of Care". Conclusion: For improving patient satisfaction, adopting appropriate strategies like performing the periodic evaluation of this phenomenon and providing some codified training in this regard are required to increase the level of moral sensitivity of physicians and provide high-quality care.

Hydro-alcoholic extract of Morus nigra reduces fasting blood glucose and HbA1c% in diabetic patients, probably via competitive and allosteric interaction with alpha-glucosidase enzyme; a clinical trial and in silico analysis.

OBJECTIVES: 1-Deoxynojirimycin (1-DNJ), the main active component found in Morus nigra (black mulberry) is reported to be effective in controlling diabetes. We have evaluated the effect of hydro-alcoholic extract of M. nigra leaves on the fasting blood glucose (FBS) and hemoglobin A1c% (HbA1c%) in diabetic patients. Furthermore, we compared the interaction of 1-DNJ and glucose molecules with the alpha-glucosidase enzyme, which has a critical role in the lysis of glucose-based polymers in human cells. METHODS: 4% hydro-alcoholic extract was prepared from black mulberry leaves. Patients in treatment (n=50) and control (n=50) groups received 3 mL extract or placebo in water, respectively, and three times a day. Fasting blood glucose and HbA1c% were evaluated before and after three months of evaluation. Potential binding sites of 1-DNJ or glucose on the enzyme glucosidase found by docking study. Docking scores were obtained using an energy minimization method by Molegro Virtual Docker software. The Mean ± SD of each variable was compared between groups at the 95% significant level. RESULTS: Age mean ± SD was equal to 54.79 ± 9.203 (38-69) years. There was no significant difference between intervention and placebo groups considering FBS (p=0.633) but was for HbA1c% (p=0.0011), before treatment. After three months, both FBS and HbA1c% were significantly reduced in patients under mulberry leaves extract-treatment. FBS changed was from 182.23 ± 38.65 to 161.23 ± 22.14 mg/dL in treatment group (p<0.001) and from 178.45 ± 39.46 to 166.23 ± 29.64 mg/dL in control group (p<0.001). HbA1c was changed from 7.23 ± 0.25 to 6.13 ± 0.61% in treatment group (p<0.001) and from 7.65 ± 0.85 to 7.12 ± 0.33% in control group (p=0.854). Docking results showed that 1-DNJ binds more efficiently, and with a significant score than glucose, to human alpha-glucosidase. CONCLUSIONS: This clinical trial and virtual analysis showed that a hydro-alcoholic extract of black mulberry (M. nigra) leaf may be efficient in reducing the blood glucose and HbA1c% in diabetic patients. Furthermore, docking studies propose a competitive and allosteric regulation for herbal ingredients. Drug-development could be based on the presented idea in this report.

Prevalence of Cystic Echinococcosis Genotypes in Iranian Animals: A Systematic Review and Meta-Analysis.

Background: Cystic echinococcosis is considered a public health problem that if left untreated can have dangerous consequences for the person. The disease is caused by Echinococcus granulosus sensu lato larvae. The main risk factors for this parasitic infection are habitat, direct contact with dogs, use of raw vegetables, and use of unwashed vegetables. The most important factors affecting the prevalence of HCD are economic, occupational, agricultural, educational, and factors related to public health and cultural habits of the general public in that geographical area. Objectives: The purpose of this study was to investigate the prevalence of the types of cystic echinococcosis genotypes (E. granulosus sensu stricto (G1-G3) and E. Canadensis (G6 and G7)) in livestock in Iran. Method: This systematic review was conducted, using Medline/PubMed, Scopus, Web of Sciences, and Google Scholar databases, to identify studies of cystic echinococcosis in animals published from 2010 to April 14, 2021. Finally, 28 studies were selected for meta-analysis, which was analyzed using Stata software version 14. The cystic echinococcosis prevalence with 95% confidence intervals of animals was synthesized using the random effect model. Heterogeneity was evaluated and in cases where the I 2 index was higher than 75%, subgroup analysis was performed according to the types of animals. Result: The highest prevalence of cystic echinococcosis infection was related to G1 genotype (P = 0.91 (95% CI = 0.84, 0.97)) and the prevalence was related to G2 genotype (P = 0.07(95% CI = 0.00, 0.18)). The results of the subgroup analysis showed that in the G1 genotype the highest prevalence was observed in Goats and Buffaloes with P = 1 (95% CI = 0.96, 1) and P = 1 (95% CI = 0.97, 1), in the G3 and G6 genotypes the highest prevalence was observed in camels with P = 0.50 (95% CI = 0.31, 0.69), and P = 0.45 (95% CI = 0.22, 0.69), respectively. Conclusion: The cystic echinococcosis genotypes vary from region to region or from country to country and also from host to host, and according to the results, it should always be stopped in areas where the prevalence of such genomes suitable for livestock as well as human food sources to prevent infection of livestock and thus human exposure to cystic echinococcosis.

Toxoplasmosis Infection in Newborn: A Systematic Review and Meta-analysis.

Background: Toxoplasmosis is a disease caused by Toxoplasma gondii, and one-third of the world's population has T. gondii antibodies. Due to this issue, the aim of this study was to assess the mean prevalence and odds ratios of T. gondii infection and epidemiological features of neonatal infection worldwide. Materials and Methods: We performed a meta-analysis and systematic review of published studies reporting T. gondii infection using the PubMed, MEDLINE, Web of Science, EMBASE, and Scopus electronic databases through January 1999 to December 2020, regarding diagnostic tests, and prevalence data of infection among the newborn population. The pooled prevalence of T. gondii with a 95% confidence interval (CI) was calculated using the random-effects models. Results: A total of thirty eligible articles were included. The estimated global prevalence rate was 44% (95% CI: 29%-0.58%); the highest prevalence rate was in America 47% (95% CI: 30%-64%), followed by Europe 41% (95% CI: 26%-57%) and Asia 33% (95% CI: 4%-61%). In this study, despite our careful analysis of possible modifiers, the heterogeneity was significant (P = 0.000). The publication bias was not significant based on the results of Egger's (P = 0.918) and Begg's tests (P = 0.230). Conclusion: Based on the results of this study, T. gondii infection can be a serious concern in newborns around the world. Therefore, further research is needed to provide better strategies to screen and diagnose T. gondii infection in neonates and determine the risk factors associated with the prevalence of infection in neonates worldwide.

Pediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 symptoms in Iran.

Aim: We report two cases of pediatric patients diagnosed and treated for pediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 (PIMS-TS) symptoms. Materials & methods: Two previously healthy 3- and 4-year-old boys were referred to the hospital after 5 days of 39°C fever, with symptoms such as erythema multiform in the lower extremities, irritability, refusal to eat, restlessness, lymphadenopathy, conjunctivitis and abnormal echocardiography. Results: After 8 days of hospitalization, the patients showed normal laboratory tests, improvement of clinical condition and were discharged from the hospital. Conclusion: This study raised several issues for physicians about SARS-CoV-2, its complications, diagnosis and treatment. Based on our results, pediatrics with PIMS-TS should be first screened for SARS-CoV-2, then treated with a combination of antivirals, anti-inflammatories, antibiotics and intravenous immune globulin.

The Effect of E-Learning on Self-Efficacy and Sense of Coherence of Cancer Caregivers: Application of the Bandura and Antonovsky Social Cognitive Theory.

AIM: Cancer is one of the most important chronic diseases which affects caregivers. Therefore, in this study, we decided to increase the self-efficacy and sense of coherence of caregivers by using virtual learning via mobile to increase the power of managing in such situations. METHODS: This study is a clinical trial performed on 60 caregivers of cancer patients. Questionnaires of demographic information, Bandura self-efficacy, and Antonovsky's sense of coherence were completed for both intervention and control groups. Then, for the intervention group, a virtual educational intervention was performed daily for 1 month using the mobile phones, and for the control group, no intervention was performed. RESULTS: The mean score of self-efficacy in the intervention group was (18.09±93.21) before and (135.12±11.14) after the intervention, which was statistically significant (P=0.001). While in the control group, this means was (84.71±18.55) before and (84.75±17.13) after the study, but this difference was not statistically significant (P=0.2). Also, the mean score of sense of coherence in the intervention group was (73.25±7.28) before and (89.11±7.11) after the intervention, which was statistically significant (P=0.001). While in the control group, this means was (76.42±7.45) before and (76.89±7.27) after the study, but this difference was not statistically significant (P=0.31). CONCLUSION: Educational interventions, even virtually, can lead to improved self-efficacy and a sense of coherence in caregivers of cancer patients and can be used as one of the low-cost and effective methods in managing and controlling the disease.

Investigation of the Epidemiological Situation and the Incidence of Covid 19 Disease in an Area of Markazi Province in Iran Country.

INTRODUCTION: Coronavirus is an emerging virus that has caused many casualties. Therefore, the purpose of this descriptive study is to investigate the epidemiological situation of coronavirus in Khomein city in the province of Markazi in Iran. METHOD: This cross-sectional descriptive study was performed on all people with coronavirus disease from the first date of admission of positive PCR of patients with coronavirus until 21 September 2020. Information on the records of definitively discharged and deceased patients due to coronavirus (having positive PCR) was extracted from 20/2/2020 to 21/9/2020 and demographic characteristics such as age, gender, area of residence, occupation, and past medical history were assessed for each patient with coronavirus disease. RESULTS: The range of age of this study was from 2 months to 95 years old and their mean age was 52.9±19.2 years old. The mean age of men and women in this study was 52.36 and 53.84 years old, respectively, which showed no significant relationship (T=0.966, N=691, P-Value=0.335, df=689). 52.1% of deaths were in rural areas and 47.9% were in urban areas. CONCLUSION: With observing the protocols by the people as well as traffic restrictions and social distance, we gradually experienced a decreasing trend in positive coronavirus cases and hospitalization cases. Then, due to the decrease in people's sensitivity and false confidence, the second outbreak of the disease began again and reached its peak in May and July.

Evaluate the Case Fatality Rate (CFR) and Basic Reproductive Rate (R-naught) of COVID-19.

INTRODUCTION: SARS-CoV-2 primarily affects a person's respiratory system and leads to the spread of pathogenicity in the person and therefore this study evaluated the Case Fatality Rate (CFR) and Basic Reproductive Rate (R-naught) of COVID-19. METHOD: This cross-sectional descriptive study was performed on all people with COVID-19 from the first date of admission of positive PCR patients with SARS-CoV-2 until September 21, 2020, in the area of Markazi Province in Khomein, Iran. Information on the records of definitively discharged and deceased patients due to COVID-19 (having positive PCR) was extracted from 20/2/2020 to 21/9/2020, and Case Fatality Rate (CFR) and Basic Reproductive Rate (R-naught) of COVID-19 were evaluated. The sample size was 691 people. RESULTS: The CFR of the COVID-19 in the current study is 6.65%, and the rate of disease transmission among the sensitive population of Khomein city at the beginning of the study (March) averaged BASIC REPRODUCTIVE RATE= 1.75, and in the last month (September) of the study This value was reduced to BASIC REPRODUCTIVE RATE= 1.306. CONCLUSION: According to our study on Case Fatality Rate (CFR) and Basic Reproductive Rate (R-naught) of COVID-19, showed that the prevalence of the disease was high in March, which due to lack of proper observance of health protocols, we saw this problem and in the months when people have more problems. Hygiene was reduced, and the rate of transmission and mortality was reduced.

The global prevalence of Toxocara spp. in pediatrics: a systematic review and meta-analysis.

BACKGROUND: Toxocariasis is a zoonotic parasitic disease caused by Toxocara canis and Toxocara cati in humans. Various types of T. canis are important. PURPOSE: The current study aimed to investigate the prevalence of Toxocara spp. in pediatrics in the context of a systematic review and meta-analysis. METHODS: The MEDLINE (PubMed), Web of Sciences, Embase, Google Scholar, Scopus, and Cumulative Index of Nursing and Allied Health databases were searched to identify peer-reviewed studies published between January 2000 and December 2019 that report the prevalence of Toxocara spp. in pediatrics. The evaluation of articles based on the inclusion and exclusion criteria was performed by 2 researchers individually. RESULTS: The results of 31 relevant studies indicated that the prevalence of Toxocara spp. was 3%-79% in 10,676 cases. The pooled estimate of global prevalence of Toxocara spp. in pediatrics was 30 (95% confidence interval, 22%-37%; I2=99.11%; P=0.00). The prevalence was higher in Asian populations than in European, American, and African populations. CONCLUSION: Health policymakers should be more attentive to future research and approaches to Toxocara spp. and other zoonotic diseases to improve culture and identify socioeconomically important factors.

The Effect of Peppermint (Mentha piperita) Extract on the Severity of Nausea, Vomiting and Anorexia in Patients with Breast Cancer Undergoing Chemotherapy: A Randomized Controlled Trial.

Background and Objective: Nausea, vomiting, and anorexia are the most common side effects reported in cancer patients undergoing chemotherapy. The present study aimed to determine the effect of peppermint extract on the severity of nausea, vomiting, and anorexia in patients with breast cancer undergoing chemotherapy. Methods and Materials: In this randomized controlled trial, we selected 84 patients with breast cancer undergoing chemotherapy. They were then assigned to 2 groups of experimental and control (n = 42, each) using block randomization. Patients in the experimental group received 40 drops of peppermint extract mixed in 20 cc of tap water every 8 hours, while patients in the control group received 40 drops of distilled water mixed in 20 cc of tap water every 8 hours. The severity of nausea, vomiting, and anorexia was measured and recorded before the intervention, and immediately, 24 and 48 hours after the chemotherapy using the Visual Analogue Scale. Statistical analysis of the data was conducted using SPSS software version 21. Results: The results of the present study revealed that there was a significant difference between the 2 groups at 24 and 48 hours after the chemotherapy (P < .05), so that the mean score of the severity of nausea, vomiting, and anorexia in the experimental group was lower than in the control group (P < .05). Conclusion: The use of peppermint as a method in complementary medicine may improve nausea, vomiting, and anorexia in patients with breast cancer undergoing chemotherapy. Further studies with greater sample size and longer follow-up period are needed to confirm the current findings.