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Maternal COVID-19 infection and the fetus: Immunological and neurological perspectives
No full textImmunoneuropsychiatry is an emerging field about the interaction between the immune and nervous systems. Infection and infection-related inflammation (in addition to genetics and environmental factors) can act as the etiopathogenesis of neuropsychiatric disorders (NPDs). Exposure to COVID-19 in utero may be a risk factor for developing NPDs in offspring in the future. Maternal immune activation (MIA) and subsequent inflammation can affect fetal brain development. Inflammatory mediators, cytokines, and autoantibodies can pass through the placenta and the compromised blood-brain barrier after MIA, leading to neuroinflammation. Neuroinflammation also affects multiple neurobiological pathways; for example, it decreases the production of the neurotransmitter serotonin. Fetal sex may affect the mother's immune response. Pregnant women with male fetuses have been reported to have decreased maternal and placental humoral responses. This suggests that in pregnancies with a male fetus, fewer antibodies may be transferred to the fetus and contribute to males' increased susceptibility/vulnerability to infectious diseases compared to female infants. Here, we want to discuss maternal COVID-19 infection and its consequences for the fetus, particularly the neurological outcomes and the interaction between fetal sex and possible changes in maternal immune responses
The effect of a theory-based health education program on physical activity and blood pressure in middle-aged women with pre-hypertension: A cluster randomized trial
No full textThe purpose of this interventional experimental study was to determine the effect of health education program on physical activity and blood pressure in middle-aged women with pre-hypertension in Kohdasht. Eighty middle-aged women with pre-hypertension were selected and divided into two groups randomly. After the one-month online training program for intervention group, by conducting an interview, the data was completed using questionnaire and it was analyzed using spss 27 software (significance level of 0.05). Before the intervention, there was no significant difference between the two groups. After 3 months of follow-up, a significant increase in attitude, perceived behavioral control and behavioral intention related to physical activity was observed in the intervention group compared to the control group (P < .05). Also, the average blood pressure in the intervention group was higher than the control group. Considering the effect of the online health education program based on the theory of planned behavior in improving the stages of changing physical activity and reducing blood pressure, the use of these developed models with an emphasis on modifying the subjective norm related to physical activity in the field of prevention is recommended for high blood pressure
A Meta-Analysis of The Prevalence and Etiology of Infertility in Iran
No full textInfertility is a serious health issue in the world affecting approximately 8-10 of couples worldwide. The meta -analy-sis study was performed to assess the prevalence and etiologic factors associated with infertility in Iran. We made sure that the implementation of study and reporting the results were consistent with the MOOSE and PRISMA guidelines, respectively. All stages of the research were conducted by two authors, and the disagreement at each stage of the re-search was resolved by consensus. On January 1, 2020, we started a detailed literature search on international online databases, and Iranian Online databases, as well as specialized journals, several authentic international publishers and Google Scholar. We reviewed the reference list of identified articles for missed articles and then searched online for them. Data analysis was performed to estimate the prevalence using a random effects model. The lifetime infertility prevalence was found to be 11.3 95% confidence interval (CI): 8.6-14.7 and the current infertility was evaluated to be 3.7% (95% CI: 3.2-4.3). The prevalence of primary infertility (based on 45 articles consisting of 51,021 samples) as well as secondary infertility (based on 13 articles consisting of 35,683 samples) in Iran were estimated to be 18.3% (95% CI: 15.4-21.6) and 2.5% (95% CI: 1.6-4.0), respectively. The prevalence of female, male, both and unexplained causes was estimated to be 32.0% (95% CI: 27.6-36.8), 43.3% (95% CI: 38.2-48.6), 12.5% (95% CI: 9.6-16.2) and 13.6% (95% CI: 10.2-17.8), respectively. The prevalence of causes related to ovulation, uterine tubes, and endome-triosis in infertile women was estimated to be 54.0% (95% CI: 45.6-62.2), 15.5% (95% CI: 11.3-21.0), 6.2% (95% CI: 3.5-10.6), and 5.4% (95% CI: 2.5-11.3), respectively. In summary, the estimate of infertility burden in Iran did not change between 1990 and 2017 and its prevalence remains high. This research presents a unified and up-to-date overview regarding the burden of infertility in Iran
Diagnosis and Treatment of Coagulopathy Caused by the New Coronavirus: A Systematic Review and Meta-Analysis Protocol
No full textBackground: The new coronavirus is an agent of respiratory infections associated with thrombosis in vital organs. This study aimed to propose a better diagnosis and treatment of coagulation disorders caused by the new coronavirus (Covid-19). Materials and Methods: Search in Cochrane central, Web of Science, PubMed, Scopus, and Ovid will be done. Also, according to the inclusion criteria, cross-sectional studies, cohort, clinical trial, and case-control will be included without gender and language restriction. Participants will also be Covid-19 patients with coagulation disorders. Any disagreement in the stages of screening, selection, and extraction of data between the two reviewers will be resolved by discussion, then if not resolved, the opinion of expert reviewers will be used. The risk of bias will be assessed using the NOS (Newcastle-Ottawa scale) tool for cross-sectional study, cohort and case-control, and the Cochrane checklist for clinical trials study. Metaanalysis of included studies that are similar based on the methodology will be done. Also, a fixed or random-effect model will be used for this it. Heterogeneity indices (I2), odds ratio (OR), risk ratio (RR), mean difference, and 95 confidence interval will also be calculated by Stata V.13.0 (Corporation, College Station TX). Results: Treatment with anticoagulants will reduce the severity of thrombosis and lung disease in patients. D-dimer measurement will also be a diagnosis indicator of thrombosis. Conclusions: Simultaneous study of coagulation disorders and thrombosis in patients and development of a Godliness based on it will play a treatment role in the follow-up of the coronavirus disease
Phototherapy Effects on Zinc Level of Neonates With Hyperbilirubinemia: A Systematic Review and Meta-analysis
No full textBackground: Phototherapy is the most common treatment of neonatal jaundice that affects the zinc level as well as the bilirubin level. Objectives: The purpose of this study is to investigate the effect of phototherapy on the zinc level of infants with jaundice by a systematic review and meta-analysis. Methods: In this systematic review and meta-analysis a comprehensive literature search of the databases, including Cochrane Library, Web of Science, PubMed, Scopus, and Google Scholar web browser was conducted using standard keywords. Data analysis of this meta -analysis was performed using STATA software, version 14 and P<0.05 was considered a significant level for tests. Results: In the five studies reviewed in this article with a sample size of 398 individuals, phototherapy increased the level of zinc Standardized mean difference (SMD): 0.88 (95% CI: 0.38, 1.38), P<0.001 and decreased bilirubin level SMD:-7.67 (95% CI:-9.11,-6.23), P<0.001 in infants with jaundice. The effect of phototherapy was on the zinc level of these groups: infants with a birth weight of 3000 to 3300 grams (gr) SMD: 1.07 (95% CI: 0.42, 1.71), P<0.001 and 3301 to 3600 gr SMD: 0.40 (95% CI:-0.32, 1.12), P=0.028, three-day-old infants SMD: 1.05 (95% CI: 0.35, 1.74), P<0.001, four-day-old SMD: 0.76 (95% CI: 0.26, 1.32), and 5-day-old ones SMD: 0.23 (95% CI:-0.01, 0.48). In addition, phototherapy affected on zinc level of those whose gestational age (GA) was 37 SMD: 1.12 (95% CI: 0.06, 2.17), P<0.001 and 38 SMD: 0.61 (95% CI: 0.15, 1.06), P=0.001 weeks. Conclusions: Phototherapy by reducing the level of bilirubin increases the level of zinc in infants with jaundice. So, the standardized mean difference of "phototherapy effects on the zinc level of infants with jaundice" decreases with increasing infants' weight, increasing infants' age, and increasing gestational age
Paternal postnatal depression: prevalence and the associated demographic and maternal reproductive factors among Iranian fathers
No full textBackgroundPaternal postnatal depression (PPND) is a critical mental health issue that may harm family members' health and relationships. The Edinburgh Postpartum Depression Scale (EPDS) is the most common self-reported questionnaire for postnatal depression screening among mothers and fathers worldwide. However, identifying fathers with postnatal depression and determining the related factors have been neglected in some countries.AimsThe present study aimed to determine the prevalence of PPND and then to identify its predictive demographic and reproductive factors. Two cut-off points (10 and 12) for the EPDS were used to detect PPND.MethodsThis cross-sectional study was conducted on 400 eligible fathers selected via multistage sampling. Data were collected using a demographic checklist and the EPDS.ResultsNone of the participants had previously been screened for PPND. The mean age of the participants was 35.53 +/- 5.47 years, and most of them were self-employed and had university degrees. The prevalence of PPND was 24.5 and 16.3 using the EPDS cut-off scores 10 and 12, respectively. An unwanted pregnancy and an abortion history were the predictors of PPND at both EPDS cut-off scores, with gravidity and the number of abortions also being associated with PPND at the cut-off score of 10.ConclusionIn line with the related literature, our results revealed a fairly high prevalence of PPND and its related factors. This indicates the need for a screening program for fathers during the postnatal period to detect and adequately manage PPND and prevent its adverse effects
Clinical Efficacy of Probiotics on Oral Health: A Systematic Review of Clinical Trials
No full textIntroduction Periodontal diseases and dental caries are the two most common dental diseases caused by the dental plaque. Objective The aim of the present study was to review the clinical efficacy of probiotics for oral health in randomized controlled trials. Methods An electronic search was conducted in December 2021 in Embase Medline The Cochrane Library ProQuest and Google Scholar using the following keywords: "mouthwash" and "probiotics". The titles and abstracts of 3,775 articles were screened and 24 publications that fulfilled the inclusion criteria were included. Results A total of 24 clinical trials were reviewed, including 1612 participants receiving either probiotics or mouth treatments. The results of this review indicated that individuals receiving probiotic products have a significant reduction (65 reduction p < 0.05) in the count of Streptococcus mutants in their mouths. It was also found that probiotic products were more effective or equal in effect compared to chlorhexidine in reducing oral pathogens, gingival index, and plaque index scores. On the other hand, the consumption of xylitol mouthwash was shown to cause an improvement in salivary parameters. Considering their safety and effectiveness, the use of probiotic products, such as kefir and mouthwashes, has been recommended against cariogenic bacteria and periodontal diseases. Conclusion Probiotics are considered a safe alternative to conventional therapies such as chlorhexidine and fluoride. Co-administration of chlorhexidine fluoride and probiotics seems to be a perfect packag
The Effect of Base Theory Educational Intervention on Health-Promoting Lifestyle in Women Susceptible to Cardiovascular Diseases: Application of the Theory of Planned Behavior
No full textBackground. Cardiovascular diseases are the second leading cause of mortality, disability, and reduced productivity in women over 40 years and the first cause of mortality in women over 60 years. Therefore, the present study aimed to determine the effect of educational intervention based on theory of planned behavior (TPB) on health-promoting lifestyle in women susceptible to cardiovascular diseases. Methods. This quasiexperimental study was conducted on 200 women susceptible to cardiovascular diseases referred to health centers in Fasa city, Fars province, Iran. The available sampling was performed on women who referred to the centers and had a family record. In this study, two health-promoting lifestyle questionnaires consisting of 49 questions and the theory of planned behavior questionnaire consisting of 50 questions were used. The obtained data were analyzed by using the SPSS software version 24 in two stages before and six months after the educational intervention through paired t-test, independent t-test, chi-square test, and McNemar test. Results. The mean age of women in the experimental and control groups was 38.74 & PLUSMN; 9.22 and 39.14 & PLUSMN; 9.08 years, respectively. The results showed a significant increase in the experimental group after six months of intervention in terms of health-promoting lifestyle and constructs of the theory of planned behavior. Also, mean blood pressure, fasting blood sugar, and smoking of experimental group decreased six months after the educational intervention. Conclusion. Considering the irreplaceable role of education in adopting healthy behaviors and the role of women in strengthening the family foundation, quality educational programs should be designed and regularly implemented by health care providers for women
Investigating the relationship between the number and activity of natural killer cells with increased cytomegalovirus and CMV disease after kidney transplantation
No full textBackground: Cytomegalovirus (CMV) infections caused by the cytomegalovirus are one of the most common problems in patients after kidney transplant. We examined the association of the relationship between the number and activity of natural killer cells with increased cytomegalovirus and its related disease after kidney transplantation.Material and methods: In this analytical study, 58 new transplant patients in the Labbafinejad Hospital, who did not have any evidence of CMV infection, were evaluated based on the number and percentage of CD56+/16+, CD56+/16-, and CD69+ Natural Killer (NK) cells.Results: The results of this study showed that CD16+ and CD56+ cells in the group of CMV Ag-positive patients are less than negative patients (p = 0.003) and the difference between the two groups are significant (p = 0.01). However, CD69+ cells did not differ significantly between the two groups (p = 0.1). Moreover, the absolute number of CD16+ and CD56+ cells declined significantly after infection with CMV unlike the CMV Ag - group(p = 0.003). Discussion: These results indicate that kidney transplant patients suffering from CMV infection after transplantation have a significantly reduced total number of NK cells. On the other hand, a slight decrease in the number of NK subgroups was observed with an increase in the peak serum levels of cyclosporine. As a consequence of these findings, it can be assumed that more dosage and a higher level of the drug will result in more severe immunosuppression and, consequently, increased susceptibility to CMV infections. Thus, taking the right dose of the drug would prevent viral infections and immune system from over-activation
The unfinished agenda of communicable diseases among children and adolescents before the COVID-19 pandemic, 1990-2019: a systematic analysis of the Global Burden of Disease Study 2019
No full textBackground Communicable disease control has long been a focus of global health policy. There have been substantial reductions in the burden and mortality of communicable diseases among children younger than 5 years, but we know less about this burden in older children and adolescents, and it is unclear whether current programmes and policies remain aligned with targets for intervention. This knowledge is especially important for policy and programmes in the context of the COVID-19 pandemic. We aimed to use the Global Burden of Disease (GBD) Study 2019 to systematically characterise the burden of communicable diseases across childhood and adolescence. Methods In this systematic analysis of the GBD study from 1990 to 2019, all communicable diseases and their manifestations as modelled within GBD 2019 were included, categorised as 16 subgroups of common diseases or presentations. Data were reported for absolute count, prevalence, and incidence across measures of cause-specific mortality (deaths and years of life lost), disability (years lived with disability YLDs), and disease burden (disability-adjusted life-years DALYs) for children and adolescents aged 0-24 years. Data were reported across the Socio-demographic Index (SDI) and across time (1990-2019), and for 204 countries and territories. For HIV, we reported the mortality-to-incidence ratio (MIR) as a measure of health system performance. Findings In 2019, there were 3 & BULL;0 million deaths and 30 & BULL;0 million years of healthy life lost to disability (as measured by YLDs), corresponding to 288 & BULL;4 million DALYs from communicable diseases among children and adolescents globally (57 & BULL;3% of total communicable disease burden across all ages). Over time, there has been a shift in communicable disease burden from young children to older children and adolescents (largely driven by the considerable reductions in children younger than 5 years and slower progress elsewhere), although children younger than 5 years still accounted for most of the communicable disease burden in 2019. Disease burden and mortality were predominantly in low-SDI settings, with high and high-middle SDI settings also having an appreciable burden of communicable disease morbidity (4 & BULL;0 million YLDs in 2019 alone). Three cause groups (enteric infections, lower-respiratory-tract infections, and malaria) accounted for 59 & BULL;8% of the global communicable disease burden in children and adolescents, with tuberculosis and HIV both emerging as important causes during adolescence. HIV was the only cause for which disease burden increased over time, particularly in children and adolescents older than 5 years, and especially in females. Excess MIRs for HIV were observed for males aged 15-19 years in low-SDI settings. Interpretation Our analysis supports continued policy focus on enteric infections and lower-respiratory-tract infections, with orientation to children younger than 5 years in settings of low socioeconomic development. However, efforts should also be targeted to other conditions, particularly HIV, given its increased burden in older children and adolescents. Older children and adolescents also experience a large burden of communicable disease, further highlighting the need for efforts to extend beyond the first 5 years of life. Our analysis also identified substantial morbidity caused by communicable diseases affecting child and adolescent health across the world. Funding The Australian National Health and Medical Research Council Centre for Research Excellence for Driving Investment in Global Adolescent Health and the Bill & Melinda Gates Foundation. Copyright & COPY; 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license