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Interventions for decreasing drug abuse and social problem in Iran's mental and social health services model (SERAJ program)
Objective: Social problems and drug abuse, especially addiction, divorce, poverty, crime, violence, alcohol consumption, and substance abuse, have increased in Iran over the past two decades. The present study aims to determine an approach to decrease drug abuse and social problems in the Islamic Republic of Iran. Method: A national program on providing comprehensive social and mental health services, entitled "SERAJ", was developed and piloted in three districts of Iran. To compile this study, three types of data collection have been used: (1) review of the literature, (2) an in-depth interview with experts and stakeholders, (3) focused group discussions. Results: In our proposed model for decreasing drug abuse and social problems, comprehensive mental and social health service are provided. Social care is integrated into the primary health care and six types of services, including social health education, screening for risk factors of social problems, and drug abuse, identifying underlying psychiatric, psychological, or social causes, short consultations, referral to social workers, and follow-up. Conclusion: Theoretically, if mental disorders are reduced, social harm and addiction will also be reduced because it is one of the important risk factors for divorce, violence, crime, drug abuse, and alcohol consumption. SERAJ reduces mental disorders; therefore, it can reduce social problems and addiction. Copyright © 2021 Tehran University of Medical Sciences
Removal of Acid Brown 354 from wastewater by aminized cellulose acetate nanofibers: experimental and theoretical study of the effect of different parameters on adsorption efficiency
Wastewater effluents usually involve dyes that are dangerous for aquatic life and other environments. Many of these dyes are toxic, carcinogenic, and can cause skin and eye irritation. In this study, firstly aminized cellulose acetate was prepared from cellulose acetate and applied for the adsorption of Acid Brown 354 from aqueous solutions. The effects of different parameters including adsorbent dosage, pH, temperature, and initial concentration of dye on adsorption capacity were examined. Results showed that removal efficiency of dye declined by increasing values of all parameters. Finally, maximum removal of dye was achieved in the presence of 0.1 g adsorbent, pH of 2, and 10 mg/L of initial dye concentration at a temperature of 25 °C. Also, different adsorption isotherms were investigated including Langmuir, Temkin, and Freundlich models and results demonstrated that the adsorption isotherm of dye followed the Freundlich model with a correlation coefficient of 0.988 revealing that the bond between the dye and the adsorbent is strong. Finally, kinetic study indicated that the adsorption of dye is exactly governed by pseudo-second-order kinetics explaining that the adsorption process is chemical and the adsorbent can not be reused. © 2021 The Author
Challenges and concerns of patients with congenital bleeding disorders affected by coronavirus disease 2019
Coronavirus disease 2019 (COVID-19) is a new medical challenge for all individuals, especially for those with underlying disorders, such as congenital bleeding disorders (CBDs). Therefore, the pandemic might significantly change the behaviour of patients with CBDs and results in some challenges. In the present study, we assessed the main challenges of COVID-19 infection to patients with CBDs. Data were collected from medical files and interviews of patients with CBDs who had COVID-19 infection. Follow-ups were performed on patients who had active severe acute respiratory syndrome coronavirus 2 infection between April and October 2020. All patients were interviewed by an expert in order to collect the pertinent data. Some questions were about patients' preventive behaviors and feelings prior to infection, and some were about the consequences of infection on patients' replacement therapy and bleeding management. Among 25 patients, infection and death of loved ones (n: 7, 28), and their own (n: 5, 20) or family members' (n: 1, 4) infection, and the resulting economic burden (n: 2, 8) were main concerns. Six patients experienced depression during the pandemic. The pandemic caused all severely affected patients but one (n: 11, 92) to abandon replacement therapy. However, two received on-demand therapy after exacerbation of their bleeding. Only one (25) of four patients on prophylaxis received in-home therapy, whereas the others (75) abandoned prophylaxis. It seems that COVID-19 infection has great consequences on the lives of patients with CBDs, causing some to take dangerous actions, such as abandonment of their treatment. Healthcare systems, and healthcare providers, should have an appropriate strategy for management of patients with CBDs that prevents infection and provides timely replacement therapy. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved
Studying the effect of vitamin d on the intensity of torsional nystagmus in Benign paroxysmal positional vertigo (BPPV) in Rohani hospital of Babol
Background: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo and nystagmus in clinics. Vertigo has many causes and the recurrence of vertigo is unknown. Among a lot of factors, vitamin D deficiency is more important. This study was conducted to determine the effect of vitamin D supplementation on torsional nystagmus in BPPV patients. This study wants to show the deficiency of vitamin D leads to the recurrence of BPPV. Methods: This case-control study was conducted from April 2017 to May 2018. All eligible patients with BPPV were presented to the Audiology clinic of Babol Rouhani hospital consecutively. Diagnosis of BPPV and the presence of nystagmus were confirmed and serum vitamin D was assessed. Dix-halpike maneuver and videonystagmography (VNG) for assessing nystagmus were done and for serologic assessment, ELISA was performed for analyzing the level of hydroxy 25 vitamin D.Vitamin D sufficient patients (more than 20 ng/ml) with BPPV were considered as the control group and vitamin D deficient patients (less than 20 ng/ml) were as the test group. In all the patients of two groups, torsional nystagmus (vertical, horizontal and oblique) were studied and compared. Results: Twenty-seven patients in each group have completed the study. The mean age of the control group and test group was 48.2+4.8, 47.8+5.7 and 47.2+4.9 years respectively (P=0.91). Two groups were comparable regarding nystagmus severity. All patients had at least two attacks During the last six months. The mean of serum 25 OHD was 33.81 in the control group and 11.41 in the test group that was statistically significant (P=0.001 for all) and the severity of torsional nystagmus in three axes of horizontal, vertical and oblique in the control group was 4.98, 9.06, 5.40 respectively and 3.32, 8.86, 6.93 in the test group that was statistically significant as compared with the control group (P=0.001). Conclusion: Findings of this study indicate a relationship between vitamin D deficiency and recurrence of nystagmus in BPPV patients. © 2021 Tehran University of Medical Sciences. All rights reserved
Predicting falls and injuries in people with multiple sclerosis using machine learning algorithms
Falls in people with Multiple Sclerosis (PwMS) is a serious issue. It can lead to a lot of problems including sustaining injuries, losing consciousness and hospitalization. Having a model that can predict the probability of these falls and the factors correlated with them and can help caregivers and family members to have a clearer understanding of the risks of falling and proactively minimizing them. We used historical data and machine learning algorithms to predict three outcomes: falling, sustaining injuries and injury types caused by falling in PwMS. The training dataset for this study includes 606 examples of monthly readings. The predictive attributes are the following: Expanded Disability Status Scale (EDSS), years passed since the diagnosis of MS, age of participants in the beginning of the experiment, participants� gender, type of MS and season (or month). Two types of algorithms, decision tree and gradient boosted trees (GBT) algorithm, were used to train six models to answer these three outcomes. After the models were trained their accuracy was evaluated using cross-validation. The models had a high accuracy with some exceeding 90. We did not limit model evaluation to one-number assessments and studied the confusion matrices of the models as well. The GBT had a higher class recall and smaller number of underestimations, which make it a more reliable model. The methodology proposed in this study and its findings can help in developing better decision-support tools to assist PwMS. © 2021 Elsevier Lt
Comparison of influenza type A and B with COVID-19: A global systematic review and meta-analysis on clinical, laboratory and radiographic findings
We compared clinical symptoms, laboratory findings, radiographic signs and outcomes of COVID-19 and influenza to identify unique features. Depending on the heterogeneity test, we used either random or fixed-effect models to analyse the appropriateness of the pooled results. Overall, 540 articles included in this study; 75,164 cases of COVID-19 (157 studies), 113,818 influenza type A (251 studies) and 9266 influenza type B patients (47 studies) were included. Runny nose, dyspnoea, sore throat and rhinorrhoea were less frequent symptoms in COVID-19 cases (14, 15, 11.5 and 9.5, respectively) in comparison to influenza type A (70, 45.5, 49 and 44.5, respectively) and type B (74, 33, 38 and 49, respectively). Most of the patients with COVID-19 had abnormal chest radiology (84, p < 0.001) in comparison to influenza type A (57, p < 0.001) and B (33, p < 0.001). The incubation period in COVID-19 (6.4 days estimated) was longer than influenza type A (3.4 days). Likewise, the duration of hospitalization in COVID-19 patients (14 days) was longer than influenza type A (6.5 days) and influenza type B (6.7 days). Case fatality rate of hospitalized patients in COVID-19 (6.5, p < 0.001), influenza type A (6, p < 0.001) and influenza type B was 3(p < 0.001). The results showed that COVID-19 and influenza had many differences in clinical manifestations and radiographic findings. Due to the lack of effective medication or vaccine for COVID-19, timely detection of this viral infection and distinguishing from influenza are very important. © 2020 John Wiley & Sons Ltd
In vitro and in vivo antidiabetic activity of Tamarix stricta Boiss.: Role of autophagy
Ethnopharmacological relevance: Type 2 diabetes mellitus (DM) is a complicated metabolic disorder with no definite treatment. Different species of the genus Tamarix (tamarisk) are used by local people to treat DM. Tamarix stricta Boiss. is an endemic species to Iran with several traditional therapeutic uses in Persian Medicine. This study aimed to assess the antidiabetic activity of T. stricta. Materials and methods: Hydroethanolic extract of the plant was prepared and analyzed by High-performance liquid chromatography (HPLC). The protective effect of the extract was evaluated in streptozotocin (STZ)-induced toxicity and markers of autophagy in pancreatic RIN-5F cells. The effect of intragastric 10 or 20 mg/kg of the extract was compared with negative control (water) or positive control (metformin) treatment during four weeks of administration in high-fat diet + STZ-induced DM in Balb/c mice. Results: Results showed the presence of 8.436 mg of gallic acid in each gram of the extract. A significant cytoprotective effect was observed by T. stricta in STZ-induced toxicity in RIN-5F cells, partially due to the modulation of autophagy. Also, animals treated with the extract showed a significant improvement in glycemic and lipid profiles, liver function, and histopathologic features of pancreas and liver compared with the negative control. Conclusion: T. stricta demonstrated beneficial effects in animal model of DM; though, further studies are recommended to confirm the clinical use of this plant in DM. © 2020 Elsevier B.V
Application of Nanobiotechnology for Early Diagnosis of SARS-CoV-2 Infection in the COVID-19 Pandemic
Abstract: A most discussed topic of the new decade, COVID-19 is an infectious disease caused by the recently discovered SARS-CoV-2. With an exceedingly high transmission rate, COVID-19 has affected almost all the countries in the world. Absent any vaccine or specific treatment, the humanity is left with nothing but the legacy method of quarantine. However, quarantine can only be effective when combined with early diagnosis of suspected cases. With their high sensitivity and unmatched specificity, biosensors have become an area of interest for development of novel diagnostic methods. Compared to the more traditional diagnostics, nanobiotechnology introduces biosensors as different diagnostics with greater versatility in application. Today, a growing number of analytes are being accurately identified by these nanoscopic sensing machines. Several reports of validated application with real samples further strengthen this idea. As of recent, there has been a rise in the number of studies on portable biosensors. Despite the slow progression, certain devices with embedded biosensors have managed to be of diagnostic value in several countries. The perceptible increase in development of mobile platforms has revolutionized the healthcare delivery system in the new millennium. The present article reviews the most recent advancements in development of diagnostic nanobiosensors and their application in the clinical fields. Key points: � There is no specific treatment for highly transmissible SARS-CoV-2. � Early diagnosis is critical for control of pandemic. � Highly sensitive/specific nanobiosensors are emerging assets against COVID-19. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature
Detection of SARS-coronavirus-2 in the central nervous system of patients with severe acute respiratory syndrome and seizures
This study was designed to evaluate whether severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can directly target the central nervous system (CNS). We present four patients suffering from the loss of consciousness and seizure during the clinical course of COVID-19 infection. In addition to positive nasopharyngeal swab tests, SARS-CoV-2 has been detected in their cerebrospinal fluid. This report indicates the neuroinvasive potential of SARS-CoV-2, suggesting the ability of this virus to spread from the respiratory tract to the CNS. © 2021, Journal of NeuroVirology, Inc