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An update review on complicated mechanisms of COVID-19 pathogenesis and therapy: direct viral damage, renin-angiotensin system dysregulation, immune system derangements, and endothelial dysfunction
No full textSARS-CoV-2 was reported as the cause of coronavirus disease 2019 (COVID-19) in late December 2019. The new virus belongs to the Coronaviridae family and the Betacoronavirus genus, according to sequencing and phylogenetic studies. Genomic sequence analysis showed that SARS-CoV-2 is similar to SARS. SARS-CoV-2 is more infectious and the high level of COVID-19 community transmission has led to a growing pandemic. Although infections in most patients with COVID-19 are moderate or mild, 20 of the patients develop severe or critical disease. COVID- 19 may affect a wide range of organs and tissues, including respiratory, digestive system, nervous system, and skin. Patients with COVID-10 have been confirmed to have renal, cardiovascular, gastrointestinal, and nervous system problems in addition to pulmonary involvement. The pathogenesis of SARS-CoV-2 is being investigated, but it is possible that the organ damage might in part be caused by direct viral damage (detection of inclusion bodies in tissues, such as the kidneys), dysregulation of the immune system, renin-angiotensin system, bradykinin pathway, and coagulation, as well as host genetic factors and their polymorphisms, which may affect the disease severity. In this review, an update on the possible pathogenesis pathways of COVID-19 has been performed. It is hoped that best care is developed for patients with COVID- 19 by identifying its pathogenesis pathways
The Effect of Appropriate Treatment Package for the Elderly on the Abuse of Rural Elderly Families in Eyvan City
No full textBackground and Aim: Elderly abuse is one of the forms of domestic violence that affects the health, safety and quality of life of the elderly. The aim of this study was to determine the effect of appropriate training package on appropriate treatment of the elderly on family abuse of rural elderly in Ivan city in 1398. Materials and Methods: This was an experimental study of pre-test-post-test with a control group. 92 elderly people living in the villages of Ivan city were selected by stepwise cluster sampling method. The research tool was a questionnaire on elder abuse. An appropriate treatment package for the elderly was provided to 46 family members in the experimental group during 8 weeks. Data were analyzed by descriptive statistics and McNemar, paired and independent t-tests and analysis of covariance in SPSS-22 software. Significance level was considered 0.05. Results: There was no physical abuse or rejection. The mean scores of elder abuses in the experimental group before and after the intervention had a significant decrease in the dimensions of emotional neglect, psychological abuse (p=0.001) and care neglect (p= 0.01). The mean scores of elder abuses in the experimental and control groups after the intervention had a significant decrease in the dimensions of emotional negligence (p=0.001) and financial negligence (p= 0.01). Conclusion: Providing an educational package for appropriate treatment of the elderly was effective in reducing some aspects of family abuse with rural elderly. It is recommended to use the mentioned educational package to change the behavior of elderly family members
Hypo- and Hyperphosphatemia at Admission as Independent Factors of Mortality of COVID-19 Patients: Findings from a Retrospective Cohort Study
No full textBackground: Electrolyte imbalances are common in COVID-19 infection and are associated with poor outcomes in hospitalized patients. Objectives: This study examined whether serum phosphate imbalances at admission are associated with mortality in hospitalized COVID-19 patients. Methods: In this registry-based single-center retrospective cohort study, 1349 inpatients with COVID-19 were included from March 2020 to March 2021 in an academic hospital in Ilam (southwest Iran). The Cox proportional hazard (PH) regression model was applied to the data set of COVID-19. Results: The in-hospital median survival time for patients with low, normal, and high serum phosphate levels was 14, 25, and 8 days, respectively. In a multivariate model, adjusted for the other variables, patients with hypophosphatemia (adjusted hazard ratio HR, 2.53; 95% CI, 1.15 - 5.58; P = 0.02) and hyperphosphatemia (adjusted HR, 1.77; 95% CI, 1.00 - 3.14; P = 0.05) had an increased mortality hazard compared with those who had normal levels of serum phosphate. Conclusions: Ourresults demonstrate associations of hypophosphatemiaandhyperphosphatemia with increased in-hospital mortality in COVID-19 patients. Intensive medical care and more attention must be paid to COVID-19 patients with serum phosphate imbalances at admission
Evaluation of the Prevalence of Congenital Heart Diseases in neonates of Ilam province of Iran, in 2019-2020
No full textBackground: Congenital heart diseases (CHDs) can cause death and severe disorders in the developmental process of children and, in most cases, are associated with other congenital defects. The current study investigates the prevalence of such defects among infants born in 2019 and 2020. Materials and Methods: This analytical cross-sectional study was conducted in Ilam province on 91 referred neonates, with the possibility of heart diseases, who were diagnosed with CHDs. Demographic, clinical, and definitive diagnoses of cardiologists were recorded and analyzed in these infants, followed by a 6-month follow-up. Data were analyzed using SPSS software with descriptive statistics, Chi-square test, and correlation coefficients. Results: A total of 91 infants out of 16,064 newborns were diagnosed with CHDs, and the prevalence of heart diseases was 5.9 in every 1000 live births. The most frequent defects were ventricular septal defects (VSDs) and PDA, with prevalence rates of 59.3 and 14.2, respectively. Among 54 VSDs, mus VSD (n = 39) was the most common form of this disorder. Conclusion: The incidence of CHDs in Ilam province was lower than the global average, which may be attributed to the easier access of several cities to the health centers of the bordering provinces. The highlighted results of this study were the frequency of VSDs and the high rates of muscular VSD compared to membranous VSD
Evaluating the Effect of an Experimental Sesame Gel on Human Enamel: Atomic Force Microscopy Study
No full textSTATEMENT OF THE PROBLEM: Every effort for increasing the calcium concentration in the saliva would be beneficial for prevention of dental caries. Regarding this issue, the natural products could be considered safer and more cost effective. Sesame is rich in calcium but the data about the effect of sesame on enamel roughness is inadequate. PURPOSE: This study aimed to assess the effect of an experimental sesame gel on the surface roughness of human enamel by using atomic force microscopy (AFM). MATERIALS AND METHOD: In the current experimental study, fifteen enamel slices with 1mm thickness were prepared. They were polished and acid etched to produce a substantial rough surface prior to the first AFM analysis. The enamel blocks were randomly divided into three groups treated with distilled water, fluoride gel, and an experimental prepared sesame gel correspondingly. The treating agent was applied for 3minutes at 0, 8, 24, and 48h intervals and washed by distilled water after each cycles. Ultimately, the final AFM micrographs were prepared. The statistical analysis was performed using paired t-test, one-way ANOVA, and Tukey Post Hoc tests (alpha=0.05). RESULTS: Statistical analysis revealed that the surface roughness was significantly reduced in both sesame and fluoride groups (p= 0.017 and 0.018, respectively) while the control group (distilled water) were not noticeably changed (p= 0.12). The control group had statistically significant difference with both the sesame and the fluoride groups (p= 0.007 and 0.007, respectively) while the there was no significance difference between sesame and fluoride groups (p= 0.997). CONCLUSION: Following demineralization by acid etched process, the sesame gel significantly reduced surface roughness of enamel and its effect was similar to fluoride gel
COMPARISON OF THE EFFECT OF SILDENAFIL AND TADALAFIL ON PULMONARY HYPERTENSION ASSOCIATED WITH HEMODYNAMICALLY SIGNIFICANT PDAS TREATMENT OF PULMONARY HYPERTENSION IN HS-PDA PATIENTS
No full textObjective: Treating the hemodynamically significant patent ductus arteriosus (hs-PDA) includes conservative therapy besides using non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. In addition, the pulmonary arterial pressure increases in hs-PDA. It is not clear whether the drugs used in acute pulmonary arterial hypertension (PAH) can improve the hs-PDA or not. This study evaluates the effect of anti-PAH drugs, sildenafil and tadalafil on patients with hs-PDA and PAH. Methods: Neonates with hs-PDA and PAH diagnosis are included in this triple-blinded clinical randomized trial study. The patients are assigned to group A (tadalafil + acetaminophen), B (sildenafil + acetaminophen), and C (acetaminophen alone). The patients were evaluated by their echocardiography findings, before and after therapy. Results: Overall, 96 patients were included in this study, 32 for each group. The patients were match for all of the demographic data. All patients had improved echocardiography parameters, except for the TAPSE and MPA diameter for tadalafil patients. On the other hand, the RVEDd and RVESd were improved better in tadalafil patients, in comparison with the sildenafil group (p = 0.012 and 0.022, respectively). There was no significant difference in other echocardiography parameters or the adverse effects. Conclusions: Using anti-PAH drugs such as tadalafil and sildenafil to hs-PDA patients with PAH does not have additional effect to the acetaminophen. Tadalafil and sildenafil did not vary in efficacy and side effects. Despite the safety of adding anti-PAH drugs such as sildenafil and tadalafil, the acetaminophen itself can reduce the pulmonary pressure by closing the patent duct. © 2022 Wolters Kluwer Medknow Publications. All rights reserved
Seroprevalence of COVID-19 in Blood Donors: A Systematic Review and Meta-Analysis
No full textIntroduction. Determining the prevalence of SARS-CoV-2 in blood donors makes the control of virus circulation possible in healthy people and helps implement strategies to reduce virus transmission. The purpose of the study was to examine the seroprevalence of COVID-19 in blood donors using systematic review and meta-analysis. Materials and Methods. The electronic databases PubMed, Scopus, Web of Science, and the Google Scholar search engine were searched using standard keywords up to 2022-04-26. The variance of each study was calculated according to the binomial distribution. Studies were combined according to the sample size and variance. Q Cochrane test and I2 index were used to examine the heterogeneity of the studies. Data analysis was performed in STATA 14 software, and the significance level of the tests was P < 0.05. Results. In the 28 papers examined with 227894 samples, the seroprevalence of COVID-19 in blood donors was 10 (95 CI: 9, 11), estimated 5 (95 CI: 4, 7) among men and 6 (95 CI: 4, 7) among women. This rate in different blood groups was as follows: A 12 (95 CI: 10-14), B 12 (95 CI: 10-15), AB 9 (95 CI: 7-12), and O 13 (95 CI: 11-16). The seroprevalence of COVID-19 in blood donors in North America 10, Europe 7, Asia 23, South America 5, and Africa was 4; Moreover, the seroprevalence of IgG antibodies was estimated to be 23 (95 CI: 18-29) and IgM 29 (95 CI: 9-49). Conclusion. The highest prevalence of COVID-19 serum in women blood donors was among blood group O and Asia. The seroprevalence of IgG and IgM antibodies was high too
Global, regional, and national burden of colorectal cancer and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019
No full textBackground Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. Methods Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990-2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. Findings Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95 uncertainty interval UI 810 408-868 574) to 2.17 million (2.00-2.34), and deaths increased from 518 126 (493 682-537 877) to 1.09 million (1.02-1.15). The global age-standardised incidence rate increased from 22.2 (95% UI 21.3-23.0) per 100 000 to 26.7 (24.6-28.9) per 100 000, whereas the age-standardised mortality rate decreased from 14.3 (13.5-14.9) per 100 000 to 13.7 (12.6-14.5) per 100 000 and the age-standardised DALY rate decreased from 308.5 (294.7-320.7) per 100 000 to 295.5 (275.2-313.0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62.0 48.9-80.0 per 100 000), Monaco (60.7 48.5-73.6 per 100 000), and Andorra (56.6 42.8-71.9 per 100 000) had the highest age-standardised incidence rates, while Greenland (31.4 26.0-37.1 per 100 000), Brunei (30.3 26.6-34.1 per 100 000), and Hungary (28.6 23.6-34.0 per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age <50 years), particularly in high Socio-demographic Index (SDI) countries. Globally, a diet low in milk (15.6%), smoking (13.3%), a diet low in calcium (12.9%), and alcohol use (9.9%) were the main contributors to colorectal cancer DALYs in 2019. Interpretation The increase in incidence rates in people younger than 50 years requires vigilance from researchers, clinicians, and policy makers and a possible reconsideration of screening guidelines. The fast-rising burden in low SDI and middle SDI countries in Asia and Africa calls for colorectal cancer prevention approaches, greater awareness, and cost-effective screening and therapeutic options in these regions. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd
Viral vector and nucleic acid vaccines against COVID-19: A narrative review
No full textAfter about 2 years since the first detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in Wuhan, China, in December 2019 that resulted in a worldwide pandemic, 6.2 million deaths have been recorded. As a result, there is an urgent need for the development of a safe and effective vaccine for coronavirus disease 2019 (COVID-19). Endeavors for the production of effective vaccines inexhaustibly are continuing. At present according to the World Health Organization (WHO) COVID-19 vaccine tracker and landscape, 153 vaccine candidates are developing in the clinical phase all over the world. Some new and exciting platforms are nucleic acid-based vaccines such as Pfizer Biontech and Moderna vaccines consisting of a messenger RNA (mRNA) encoding a viral spike protein in host cells. Another novel vaccine platform is viral vector vaccine candidates that could be replicating or nonreplicating. These types of vaccines that have a harmless viral vector like adenovirus contain a genome encoding the spike protein of SARS-CoV-2, which induces significant immune responses. This technology of vaccine manufacturing has previously been used in many human clinical trials conducted for adenoviral vector-based vaccines against different infectious agents, including Ebola virus, Zika virus, HIV, and malaria. In this paper, we have a review of nucleic acid-based vaccines that are passing their phase 3 and 4 clinical trials and discuss their efficiency and adverse effects
Linezolid resistance in multidrug-resistant mycobacterium tuberculosis: A systematic review and meta-analysis
No full textIntroduction: Linezolid (LNZ) is an effective antibiotic to treat patients with multidrug-resistant tuberculosis (MDR-TB) treatment failure. M. tuberculosis strains resistant to isoniazid and rifampin are defined as MDR-TB. In recent years, resistance to LNZ among MDR-TB cases has been reported in several different countries. In this study, we performed a systematic review and meta-analysis to investigate the prevalence of LNZ resistance among MDR-TB isolates. Methods: The databases of Embase, PubMed/Medline, and Web of Science were searched systematically from January 2000 to April 2021. Statistical analyses were performed by using Comprehensive Meta-Analysis software. Heterogeneity was reported by using the t-squared statistic and Q-statistic. Begg's rank correlation in combination with the funnel plot were used to evaluate any possible publication bias. Results: In total, 25 studies were selected for meta-analysis from 14 different countries; the majority was from China (n = 5) and Turkey (n = 4). Moreover, 7,366 patients were infected with MDR M. tuberculosis. Among the study population, 98 patients were co-infected with HIV, and 18 patients with hepatitis C virus (HCV). Furthermore, 28 cases had diabetes, and139 cases were alcohol abuser. Overall, 4,956 MDR M. tuberculosis strains were isolated from TB patients. The pooled frequency of LNZ resistance among the clinical isolates of MDR M. tuberculosis was 4.2 (95). Begg's (p = 0.72) test showed no evidence of publication bias. Conclusion: LNZ resistance among MDR M. tuberculosis isolates is increasing. On the other hand, long-term treatment of MDR-TB cases with LNZ alone is associated with several adverse effects. Thus, it is recommended that newer anti-TB drugs, including bedaquiline and delamanid, in combination with linezolid could increase its effectiveness and decrease toxicities. However, more studies should be done in this field