امین عطائی

Laryngeal Mask Airway (LMA) is commonly used in short-term surgical anesthesia. Intravenous lidocaine is used for better patient tolerance after LMA insertion. Regarding the side effects of intravenous lidocaine, the aim of this study is to compare the effect of lidocaine spray versus intravenous lidocaine on blood pressure, heart rate, sore throat, cough, laryngospasm, and other side effects including nausea, vomiting, and convulsions after LMA insertion.

This double-blind randomized clinical trial was conducted on 120 patients aged 18-65 years with indications for short-term elective eye surgery, in 2 equal groups of 60 people. The first group was given 1% intravenous lidocaine at the rate of 1.5 mg/kg, and the second group was administered with 5 puffs of 10% lidocaine spray in the throat. Then, blood pressure by a sphygmomanometer, heart rate by a heart rate monitoring system, sore throat intensity based on VAS criteria, and cough intensity based on mild, moderate and severe were measured and compared in the two groups.

79 men (65.8%) and 41 women (42.2%) participated in this study. Clinically, there was no significant change in blood pressure in the two groups. The mean intensity of sore throat two and three hours after waking up in lidocaine spray group (0.51±1.33 and 0.41±1.07) compared to intravenous lidocaine (1.15±2.02 and 1.9±1.08) showed a significant decrease (p<0.05). Also, there were no significant changes in heart rate, cough and laryngospasm between the two groups. In addition, no cases of nausea, vomiting and seizures were found in the two groups.

Based on the results of this study, lidocaine spray can be suggested to reduce the severity of sore throat caused by LMA insertion.

Depression is a common psychiatric disorder.There are some studies about anti-depressant effect of piperien. This study is about the synergistic effect of piperine and memantine on behavior improvement and BDNF gene expression in depression model in rat brain.

In this experimental study, Wistar rats were divided into four groups: Negative control which received no drug, Positive control that received only 20 mg/kg corticosterone i.p., group 3 which received corticosterone+piperine (10 mg/kg, i.p.), and group 4 that received corticosterone + piperine (10mg/kg) + memantine (3mg/kg). After three weeks, the forced swim test for depression, the Plus-Maze test for anxiety and Openfield test for locomotor activity assay were done. Data analysis was carried out by One-way ANOVA and Tukey's test. The study of BDNF gene expression was also performed using Real-time PCR.

The results of water swim test and plus-maze showed a significant difference between corticosterone+piperine+memantine group and corticosterone+piperine(P<0.05). The gene expression study revealed that increased expression of BDNF occurred in piperine+corticosterone group and piperine+ memantine+corticosterone group compared with coticosterone alone group and piperine+corticosterone+ memantine group compared with piperine+corticosterone group (P<0.05).

In current study, piperine and memantine alone and in combination diminished depression and anxiety that also caused increased BDNF expression.

Overall, the four categories of non-communicable diseases (NCDs) (Cardiovascular disease (CVD), Cancer, Diabetes and chronic respiratory diseases) contribute to over 80% of annual premature deaths, with more than 85% of these occurrences transpiring in low- and middle-income countries. This study seeks to assess the likelihood of premature mortality attributable to these diseases across the provinces of Iran.

Data on causes of death from 2016 to 2019 was extracted from the death registration system of the Ministry of Health and Medical Education. To assess the completeness of the death registration system on a provincial level, we employed a novel method introduced by Adair and Lopez.

From 2016 to 2019, non-communicable diseases, specifically the four primary diseases, constituted 68.98%, 69.44%, 69.17%, and 67.94% of all causes of death in Iran, respectively. During the same period, the probabilities of premature mortality attributed to major non-communicable diseases were 14.95%, 15.15%, 15.25%, and 16.63%, respectively. Notably, Golestan province exhibited the highest probability of premature death.

The percentage of probability of death resulting from non-communicable diseases is a crucial indicator for the prevention and control of NCDs at both the international and national levels. This indicator requires ongoing monitoring to effectively address the issue. Given the diverse socioeconomic and epidemiological circumstances across the provinces of Iran, acquiring a comprehensive understanding of the current situation regarding these diseases becomes imperative. Such knowledge facilitates the development of well-informed planning and policy-making strategies aimed at managing the increasing burden of NCDs and ensuring equitable healthcare provision.

In December 2019, a new disease was reported in China that spread rapidly worldwide. This disease is called COVID-19, a viral infection of the coronavirus family. COVID-19 has caused health, social and economic problems around the world. In Iran, the first disease cases were reported in February 2020. This article aimed to describe the results of the fourth step of the National Mobilization Plan against the COVID-19 pandemic.

The information used in this cross-sectional-descriptive study is based on the data recorded in the computer program (Portal) of the Network Management Center of the Ministry of Health and Medical Education.The fourth step was devised to manage and control the COVID-19 pandemic with public participation and coordination between departments. It comprised four teams, including contact tracing, home care, supervisory, and support teams. Excel 2016 software was used to analyze the present study's data, and ArcMap software version 10.8 was applied to draw thermal maps.

In this study, every contact-tracing team consisted of 3.2 members. This number was equal to 3.2, 2.9, and 3.8 people per team for supportive, home care, and supervisory teams, respectively. Also, on average, the contact-tracing teams tracked 135.9 cases per team. This number was 518.6 visits per team for supervisory teams, 75.3 for home care teams, and 52.2 households for support teams. During the program's implementation, 3065.3 PCR tests and 3596.7 rapid tests were taken per 100,000 population, of which 15.5% were positive. The average contact tracing in people with close contact with the infected people was 4.87 per patient with a positive test.

The COVID-19 pandemic challenged all political, economic, social, and health policies and revealed the governments’ inadequencies. Statistical evidence suggests that the measures taken to manage and control COVID-19 in Iran have been valuable and effective. Still, this process depends on the persistence of policies and protocols by the government and society.

One of the most effective ways to prevent coronavirus disease 2019 (COVID-19) is to perform general vaccination and actively prevent the outbreak at the primary health care level. The present study aimed to review the measures against COVID-19 in Iran from April to September 2021.

A cross-sectional and descriptive study was conducted at the national level from April to September 2021. Data related to COVID-19 vaccination, prevention, care, and outpatient services was collected from databases, including first level electronic health record systems, the portal of Network Management Center, the portal of Infectious Diseases Management Center, and the portal of Health Observatory. The target population of the study included medical universities and schools in Iran. Using a census sampling method, all 63 medical universities and schools in the country were included in the study. The Statistical Package for the Social Sciences (SPSS) version 16 was utilized to analyze the collected data.

In the fifth step of the national mobilization program against COVID-19 epidemic, a total of 1,228 vaccination centers with 6,490 stations were established across the country from April to September 2021. In these centers, more than 47 million doses of the COVID-19 vaccines were injected. At this step, over 15 million people exposed to close contact with infected people were intercepted. A home care team was deployed at each selected health center for COVID-19, providing 532,551 home care services. At the fifth step, the monitoring teams issued 1,015,831 warnings to trading, industrial, or administrative units, which led to the sealing of 73,443 units. Also, more than six million rapid tests were performed in homes and health units. During the same period, 30,843 vulnerable households received support packages.

The national mobilization program to combat COVID-19 in Iran focused on the community and primary health care system. The program was successful in strengthening the health system to expand vaccination and actively prevent COVID-19 epidemic.

COVID-19 is a global pandemic and has plagued many countries with unprecedented management problems. The rapid spread of COVID-19 around the world has reduced the ability of countries to address and respond to essential health services. Most countries have taken steps to prevent the spread of COVID-19 and improve essential services. The National Mobilization Plan (NMP) against COVID-19 in Iran’s healthcare system was implemented in 5 stages until September 2021. This study aimed to assess and review medical universities' performance in the third step of management and control of COVID-19 to provide documents and reports to be used in similar experiences.

This research is a cross-sectional descriptive study. Data were obtained from electronic records at the primary health care facilities and were analyzed and reported using descriptive statistical methods, including comparative tables and graphs. In order to prepare the report, Excel 2016 software was used. The third step of the NMP against COVID-19 was implemented from August 10, 2020, to November 10, 2020. In this step, while re-emphasizing the importance and necessity of verbal and laboratory screening of COVID-19, essential health services provision was highlighted as "in-person and remote services" for the covered population.

In the third step of national mobilization, 59,109,413 people were screened for COVID-19. During the third step, non-COVID essential services increased compared to the previous three months, with the most significant increase in middle-aged care.

Implementing the third step of NMP against COVID-19 in Iran increased the healthcare service delivery to all target groups, indicating the effectiveness of the third step in the fight against COVID-19 and the provision of Essential Health Services.

In order to address the community’s health needs during the COVID-19 crisis in 2020, several comprehensive urban health centers affiliated with the primary healthcare system were designated as COVID-19 centers. Considering the importance of evaluating the performance of the mentioned centers and ensuring the continuity of the services provided in accordance with the rules and instructions, the performance evaluation of the mentioned units was conducted from July 2020 to March 2021 in three levels: self-evaluation (first-level evaluation), university evaluation (second-level evaluation) and the evaluation of the experts of the Ministry of Health and Medical Education (third-level evaluation).

This cross-sectional descriptive-analytical study was conducted in all selected COVID-19 centers, including 978 in 63 universities / medical schools across the country in 2020. The sample was selected by census sampling method and included a total of 978 centers. In this study, 28 main criteria in the fields of education and information, safety of staff and clients by observing social distance, use of personal protective equipment, supplying manpower and equipment, disinfection, and work processes, and 91 sub-criteria were determined by using Delphi Technique.

With the criteria and sub-criteria defined in the areas of "community education and information", staff training, observance of social distance, facilities, waste management, manpower supply, supply of medical equipment and work processes, it was identified that in the self-evaluation (first level evaluation), the criterion with the lowest score was "staff training". The lowest score in the evaluation of the level of universities / medical schools (second level evaluation) was related to the observance of social distance in the centers and the highest score in both evaluation levels was related to the criterion of "providing the necessary education to patients regarding prevention and control of COVID-19".

The establishment and setting up of selected COVID-19 centers has been one of the effective measures in controlling and managing the COVID-19 epidemic, which was created as a result of changing the structure of the primary healthcare system. The continuity of service quality of selected centers requires continuous monitoring and evaluation of their performance.

 Diabetes mortality undergoes a growing trend worldwide that results in reducing life expectancy in society. Diabetes has been a significant health challenge in recent decades and imposed a lot of economic burden on the community. The present study aimed to evaluate the trend of diabetes mortality in Iran over five years.

The mortality data published by the Ministry of Health and Medical Education has been used in this analytical cross-sectional study. The number and rate of diabetic cases are specified based on age, gender, location, and the death process from 2006 to 2010.

 About 54.9% and 45.1% of the deaths occurred in women and men, respectively, with a male to female ratio of 0.82. The highest death rate was observed in individuals aged above 70 and 50-69 years with an average age of 68.1 years. A higher mortality rate was observed in the cities than in the countryside, and 40% of deaths occurred due to non-insulin-dependent (type II) diabetes mellitus.

 Diabetes mortality has increased from 2006 to 2010. Higher deaths were observed in women and cities. Considering the increasing population of older adults in Iran, diabetes prevention and control interventions can be carried out through screening, planning, and education.

The behavior of a suggested concrete precast beam-column connection with two different plain and high performance fiber HPFRCC concretes under increasing cyclic loading and constant axial loading are analyzed and investigated in this paper. The internal precast concrete beam-column connection was initially designed based on ACI 318 design code and modeled with finite element method and the analytical results was verified with experimental results and then there was appropriate collaboration between both results.  The numerical models with congested and non-congested stirrups in the critical zone were created and the behavior of connection under cyclic reversal loading were compared with considering two different concrete as regular and HPFRCC.  The results from non-linear finite element analysis indicated that with increasing concrete strength, the stiffness and ultimate strength of connections increased up to 10% and the ductility of connection cast with HPFRCC concrete was significantly increased up to 35%  with congested stirrups.

Visceral leishmaniasis is a zoonotic diseases and is endemic in northwest of Iran and annually 100-300 positive cases are reported. The aim of this study was to determine the spatial distribution of visceral leishmaniasis in East Azerbaijan province.

This is a retrospective cross-sectional study that was done on visceral leishmaniasis patients from 2009-2016 which is analyzed based on interpolation and SPSS v.25 and ArcMap10.4.1 have been used.

Totally 78 patients were identified during the study, of which 57.7% were living in rural areas and 42.3% in urban areas. More than 90% of cases have occurred in children under the age of 5 years. The northeastern part of the province, which has a higher average rainfall and a moderate temperature, was identified as a high risk area of the disease and a hot spot of disease among the Kalibar and Ahar counties.

Visceral leishmaniasis has increased by 3-4 times since 2013 in East Azarbaijan province and residents of border areas with Ardebil province and Azerbaijan Republic are at the risk of transmitting the disease

Accidents are one of the main causes of death worldwide. Iran has one of the highest death rates due to unintentional injuries among countries. The first step in preventing and controlling accidents is collecting basic information about the severity and type of injuries. This study was conducted to estimate the burden of death due to accidents and injuries in Ardabil province. Death information was extracted from the death registration program of Ardabil University of Medical Sciences. The World Health Organization website has been used to calculate the number of years lost in life. A total of 402 deaths due to accidents have been registered of whom 76.9% were male and 23.1% were female. The average age of the deceased was 39.4 (SD) and 54.2% lived in urban areas and 45.8% lived in rural areas. The YLLs for the total population was 16493 years. The largest amount was related to traffic accidents with 6628 years. The highest number of years was lost in the age group of 20 to 24 years.
Conclution: The incidence of death from accidents was estimated to be 31.64 in 100,000 people. Considering the high mortality rate and the resulting YLL in Ardabil province, this issue should be considered as a serious public health problem and planning to prevent these injuries.

Annually, about 1.5 million deaths occur due to tuberculosis in the world. The tenth grade is the global burden of diseases and it is expected to maintain its rank by 2020. On the other hand, information about the death and its causes are essential for assessing the health status of the region and analyzing health plans and interventions. In this study, data from deaths in Iran from 2006 to 2010 published by the Ministry of Health was used. Death data from tuberculosis during the study period and mortality rates were determined based on age, sex, and residence, and the trend of mortality from tuberculosis was determined. Data analysis was performed using Excel 2016 software. In total five years, 60.7% of deaths were related to males and 39.3% were females. The highest mortality rate was due to pulmonary tuberculosis with 87.7%. Also, death from tuberculosis in urban areas is more than rural areas. In terms of age, the highest number of deaths is in the age group above70 years. The results of this study showed that the trend of death due to tuberculosis is decreasing, but this process is very slow. In order to achieve the Millennium Development Goals, basic measures such as education, disease screening, early treatment should be taken into consideration.

Background and purpose: The Child Mortality Index is an important part of the Millennium Development Goals. Every year, 6 million children die in the world. Death information is essential for prioritizing interventions and planning and recognizing the effectiveness of the interventions. This research was conducted to study the death of children aged 1-59 months in Ardabil province, Iran. All deaths in Ardabil province from 2011-2015 in children aged 1-59 months were extracted. The distribution of death was determined based on location, sex, and place of residence and the relationships between these items were investigated using SPSS V23. A total of 553 deaths was recorded and male death included 56.2%. Death at hospital occurred in 64.7% and death in urban areas accounted for 55.9% of all deaths. Death in children aged 1-12 months was observed in 57.1%. There was a significant relationship between sex and place of residence. The trend of death in children showed a rise during the 5 years studied. The main causes of death according to death records in Health Department and hospitals were congenital anomalies and chromosomal aberrations. The main causes of death could be prevented in children, therefore, precise planning is needed to reduce the mortality rate in this population. We observed similarities between the causes of death in hospital and the causes of death in the community, so, hospital data could be of great benefit in appropriate planning.

Chikungunya virus is a mosquito-transmitted alphavirus that causes chikungunya fever, a febrile illness associated with severe arthralgia and rash. Chikungunya virus is transmitted by culicine mosquitoes; Chikungunya virus replicates in the skin, disseminates to liver, muscle, joints, lymphoid tissue and brain, presumably through the blood. Laboratory diagnosis relies upon the detection of the virus on early samples and/or specific anti-CHIKV IgM and IgG on blood samples. For diagnosis, monitoring, detection and genotyping of CHIKV, conventional reverse transcription-polymerase chain reaction (RT-PCR) methods have been used. Regarding the detection of CHIKV-RNA, other teqniques based on RT-PCR involved qRT-PCR, A SYBR Green I based quantitative RT-PCR assay and DANP- RTPCR.

Type 2 diabetes mellitus (DM) is a metabolic disorder that is common throughout the world. Meta-analysis is a statistical technique in which the results of two or more independent studies, with similar objectives, are mathematically combined in order to improve the reliability of the results. The aim of this study was to compare the efficacy of metformin and linagliptin in patients with type 2 diabetes.
To identify relevant studies, PubMed, ISI Web of Science, Embase, Cochran library, Scopus and Ovid databases were searched from January 2000 to August 2016. Mean difference (MD) with 95% confidence interval (CI) for efficacy were calculated and pooled analysis was performed using Stata V.12 and RevMan V.5.3 software.
Four studies recruiting1260 patients with DM (682 patients in group linagliptin and 578 patients in metformin group) were included in this study. The MD of HbA1C outcome of 0.5 mg linagliptin was effective (0. 7295, % CI = 0. 69 - 0. 75). The MD of fasting blood sugar (FBS) test revealed that linagliptin was effective at 0.5mg (MD = 36.79, 95% CI = 35.20 - 38.38) and 5 mg (MD = 12.65, 95% CI = 2.68 to 22.63) doses.
Our results suggest that some doses of linagliptin versus metformin may be an effective treatment for DM2. However, the number of studies was limited, and further research is needed.

Resveratrol is a phenolic herbal compound which has been proposed as antioxidant in combinational therapy of diabetes, cancer and some neurodegenerative diseases. This study was done to evaluate additive effect of trans-resveratrol and imipramine to reduce depressive symptoms in the forced swimming test in mice.
In this experimental study, 56 Swiss Webster male mice were randomly allocated into 6 groups including negative control group (normal saline), positive control (imipramine (10 mg/kg/bw), experimental groups; trans resveratrol (10 mg/kg/bw), Imipiramine (10 mg/kg/bw) and mixtures (with ratio of 1:1 of resveratrol with imipramine (2.5 mg/kg/bw, 5 and 10 mg/kg/bw), intraperitoneally. The forced swimming test has been done for all groups. Through swimming of animals in water, the immobilization times of animals as depressive symptom were recorded.
The immobilization times significantly reduced in animals which were received imipramine 10 mg/kg/bw in compare to control group (P According to additive effect of imipramine with resveratrol we can suggest resveratrol in combinations with other antidepressants to lower their doses and related side effects of chemical drugs.

Aging is the major risk factor for neurodegenerative diseases and oxidative stress is involved in the pathophysiology of these diseases. Oxidative stress can induce neuronal damages and modulate intracellular signaling, ultimately leading to neuronal death by apoptosis or necrosis. In this study, we investigated the possible antioxidant and neuroprotective properties of the polyphenolic antioxidant compound, Curcumin against homocysteine (Hcy) neurotoxicity. Curcumin (5, 15, 45 mg/kg) was injected intraperitonealy once daily for a period of 10 days beginning 5 days prior to Hcy (0.2 μmol/μl) intracerebroventricular injection in rats. Biochemical and behavioral studies, including passive avoidance learning and locomotor activity tests were studied 24 h after the last curcumin or its vehicle injection. Also Histopathological studies and cell dencity in different regions of hippocampus was investigated. Hcy could induce lipid peroxidation and increase MDA and SOA levels in rat's brain. Additionally, Hcy impaired memory retention in passive avoidance learning test. However, Curcumin treatment decreased MDA and SOA levels significantly as well as improved learning and memory in rats. Histopathological analysis also indicated that Hcy could decrease hippocampus cell count and Curcumin inhibited this toxic effect. These results suggest that Hcy may induce lipid peroxidation in rat's brain and decrease hippocampus cells. Also polyphenol treatment (Curcumin) has the ability to improve learning and memory deficits by protecting the nervous system against Oxidative stress. Keywords: Homocysteine, Curcumin, Lipid peroxidation, Oxidative Stress