فهرست مطالب maryam emadzadeh

Body hair removal plays an important role in beauty standards, particularly for women. Finding a method that is easy to use, cheap, and can be done without supervision can significantly affect long-term hair reduction and reduce the side effects of hair removal. The present study investigated the impact of a containing 20% broad bean (Vicia faba) extract cream on axillary hair removal. Twenty-five female volunteers were randomly divided into A (right axillary intervention - left axillary placebo) and B (right axillary placebo - left axillary intervention). Depending on the group, each person used a cream containing 20% broad bean extract )"The extract made from the seeds and pods of broad beans.") on one side and a placebo on the other twice a day for three months. Volunteers shaved their axillary hairs three days before each visit and took pictures of both sides on the day of the visit with a trichoscope (to check the diameter and thickness of the hairs). We found a decrease in thickness on the intervention group (the axilla where a cream containing broad bean extract was applied); however, this difference was not significant between the intervention side and the placebo. In terms of the number of hairs, the difference between the two groups was significant only in the second month despite the decrease on the intervention side. Evaluation based on the personal judgment of the volunteers showed that there was a substantial difference in terms of the number of hairs (p=0.012) and thinning of hair (p=0.02). Our findings showed that 20% broad bean extract cream could potentially reduce axillary hair growth.

The attentive management of rheumatoid arthritis (RA) has attracted particular attention. The German 7-joint Ultrasound (US-7) is the first scoring system that combines bone erosions and soft tissue lesions in a single composite scoring system. This study aimed to assess the correlation between US-7 and Disease Activity Score Using 28 Joint Counts (DAS28) in clinically active RA patients. The efficacy of a novel ultrasound score-based system, the US-9 score (joints assessed with US-7 plus knees), was also compared with the standard US-7 score.

All the RA patients referred to the outpatient rheumatology clinic of Ghaem Hospital, Mashhad, Iran, during 2019-2020 were included. 28 joints were clinically examined to calculate DAS28. Nine joints were assessed comprising the German US-7 plus knees using grayscale ultrasonography (GSUS) and power Doppler ultrasonography (PDUS). Retrieved data were analyzed by SPSS software, version 22. The Spearman Correlation test was used to find the correlation between DAS28 and ultrasonographic findings. The statistical significance level was set at P<0.05. 

This study was composed of thirty-five RA patients with a mean age of 49.1±12.0 years. US-7 synovitis scores in GSUS and PDUS were significantly correlated with DAS28 (P=0.02, r=0.38 and P=0.003, r=0.48, respectively). US-9 synovitis scores in GSUS and PDUS were also significantly correlated with DAS28 (P=0.003, r=0.49 and P=0.006, r=0.45, respectively). The synovitis score measured by GSUS was significantly correlated with the GSUS knee synovial score (P=0.01, r=0.42).

Ultrasound assessment of large joints such as knees can be an effective approach to determining RA severity. However, it can be proposed that adding more involved joints into the sonographic assessment does not necessarily provide a better clinical correlation.

Asthma is a common disease and curcumin has modest effect in inflammatory disorders. This study investigated the efficacy of nano-curcumin on asthma.

In this double-blinded randomized clinical trial, 60 patients with non-atopic bronchial asthma were randomly stratified in two groups of intervention (N=30) and control (N=30) groups. Apart from their standard treatment, the intervention group received 40 mg nano-curcumin (soft gel) three times daily while the control group received placebo. During the 60-day study, patients were assessed using spirometry to measure Forced expiratory volume in first second (FEV1). Asthma control test (ACT) was completed every 30 days and asthma quality of life questionnaire (AQLQ) was completed at the first and end of the study.

Totally, 31 patients (51.7%) were male and the mean age was 51.45±12.58 years. FEV1 was improved but there was no significant difference between intervention and control groups. ACT and AQLQ domains scores significantly improved. However, it was not statistically different between control and intervention groups.

Nano-curcumin at administered dosage had no additive effect on the standard treatment in asthmatic patients.

The current study intends to assess the impact of oral selenium intake on anti-Tg antibody in individuals with autoimmune hypothyroidism.

In this double-blinded randomized controlled trial, two groups of 72 autoimmune hypothyroid patients were randomly assigned; One group received levothyroxine (LT4) and oral selenium and the other group was given placebo with LT4. Anti-Tg antibody, free T4, anti-TPO antibody, and TSH were identified in both groups before the treatment and also 3 months after treatment and analysis of data was done by SPSS software.

After the intervention, the average amount of anti-Tg antibody decreased in both of the groups, and this decrease was noticeably greater in the intervention group (P = 0.03). In the intervention group, the TSH level decreased after the intervention (p < 0.05), and the free T4 level increased after the intervention (p < 0.05); the changes in these two variables were statistically significant.

Consumption of selenium, compared to placebo, in patients with autoimmune hypothyroidism drastically reduces the level of anti-Tg antibody, and it significantly increases the free T4 level. Also, there is a greater decrease in the level of TSH compared to the control group.

 Currently, the Internet is widely used by students for academic purposes; however, excessive Internet use might have negative consequences on students’ academic performance, sleep quality, and cognitive abilities.

 This study aimed to investigate the relationship between Internet usage, sleep quality, and cognitive function among medical students.

 This analytical cross-sectional study was conducted on 525 pre-internship medical students, including 304 first- and second-year students, 113 third-year students, and 108 externs, within 2019 and 2021 at Mashhad University of Medical Sciences, Mashhad, Iran. The participants were selected using a stratified sampling method. All participants completed the Cognitive Ability Questionnaire (CAQ), Internet Addiction Questionnaire (IAQ), and Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using SPSS software (version 22).

 According to the IAQ, 430 participants (81.9%) were categorized as average Internet users, 94 participants (17.9%) had occasional or frequent problems, and 1 participant had significant problems with Internet use. Mean PSQI and CAQ scores were significantly higher among participants with occasional or frequent problems/significant problems than the average Internet users (P < 0.001 each). The total IAQ score showed a positive correlation with total CAQ (r = 0.439, P < 0.001) and total PSQI (r = 0.264, P < 0.001) scores. Among the PSQI subscales, sleep latency (P = 0.032), daytime dysfunction due to sleepiness (P < 0.001), sleep efficiency (P = 0.001), and overall sleep quality (P < 0.001) were worse in participants with occasional or frequent problems/significant problems than in average Internet users.

 Excessive Internet use negatively affects the sleep quality and cognitive performance of medical students.

Benign prostatic hyperplasia is a common condition in older males that causes bothersome symptoms. The purpose of this study is to evaluate the combined impact of curcumin and anticholinergic therapy in managing urinary irritation symptoms in patients with benign prostatic hyperplasia following prostate surgery. This randomized clinical trial included patients with benign prostate hyperplasia who experienced irritating symptoms after prostate surgery at Imam Reza Hospital in Mashhad from 2019–2020. Participants completed the IPSS questionnaire before the operation and were then classified into two groups. One group received anticholinergic therapy, and the other group received anticholinergic therapy plus curcumin BID for one month. The IPSS was used again at the end of one month, and results were analyzed using SPSS statistical software. 80 participants were included in this research, with an average age of 63.4±13.5 years in the control group and 64.6±9.5 years in the intervention group. Before the intervention, scores for urinary frequency (P-value=0.333), urinary urgency (P-value=0.387), nocturia (P-value=0.807), and total urinary symptom score (P-value=0.061) differed between the two groups. However, after the study, the intervention group had significantly lower scores for urinary frequency, urinary urgency, and total urinary symptom score compared to the control group (P-value<0.05). No significant difference was between two groups considering nocturia (P-value=0.051). This investigation was one of the first randomized clinical trials to evaluate curcumin's effects on reducing symptoms of benign prostatic hyperplasia. The results indicated that curcumin positively impacted decreasing these symptoms, although changes in nocturia were not significant.

Diabetic nephropathy is the main cause of end-stage kidney disease in diabetic patients. Several inflammatory markers related with diabetic nephropathy have been investigated so far. It is necessary to identify easily available and cost-effective indices. We aimed to determine the relationship between the neutrophil to lymphocyte ratio and mean platelet volume with diabetic nephropathy.

This cross-sectional study was performed from 2021 to 2022 in diabetes clinic of Ghaem hospital, Mashhad.  Patients with type II diabetes were categorized into two groups: without and with nephropathy (urinary albumin excretion greater than 30 mg/24h or GFR less than 60). Patients’ data, including demographic data, past medical and drug history and lab data were gathered and analyzed.

In total, 100 diabetic patients including 50 with (mean age=64.04±7.40 years) and 50 without nephropathy (mean age=56.06±6.36 years), were studied. Patients with nephropathy were older, had a longer history of diabetes and a higher blood pressure (P < 0.05). However, the distribution of gender, weight, height, and BMI was not significantly different the two groups (P>0.05). The absolute neutrophil count was not significantly different between the two groups (P>0.05), while the mean platelet volume, neutrophil% and neutrophil/lymphocyte ratio were significantly higher in patients with nephropathy (P<0.05).

According to our findings, patients with diabetic nephropathy had higher mean platelet volume, neutrophil%, and neutrophil/lymphocyte ratios compared to diabetic patients without nephropathy.

The rate of olfactory loss related to COVID-19 was reported between 4-89 percent. There is no approved treatment for patients who experience anosmia after the mentioned infection. This systematic review aimed to assess the therapeutic effects of corticosteroids on anosmia in COVID-19 patients.

Databases including PubMed, ISI Web of Sciences, Scopus, and Cochrane Library. Databases were searched up to September 2022 to find out randomized controlled trials that assessed the effect of corticosteroids on post-COVID anosmia/hyposmia. Only studies published in the English language were entered in this review.

Among the six relevant trials with a total population of 712, one study administered the combination therapy of both systemic and nasal corticosteroids, while others used intranasal corticosteroids. No significant difference was observed between the intervention (IG) and control (CG) groups in terms of duration of improvement from anosmia (mean difference:-1.799). The pooled effect of self-rating olfactory scores was assessed at 2 weeks and at the end point of the studies which revealed no significant effect in favor of the IG (pooled effect in 2 weeks: 0.739; in the endpoint: 1.32). The objective evaluation with different tools indicated that IG obtained higher scores at the endpoint of treatment. The pooled results showed that the number of patients who recovered from anosmia is higher in IG compared to CG (Odds Ratio: 1.719).

It appears that the duration of corticosteroid therapy more than two weeks may be a considerable effect on the recovery of smell dysfunction in COVID-19 patients

Following thyroidectomy, radioiodine therapy is the standard management of differentiated thyroid cancer. The effects of such treatment on testicular function remained a concern for cases and clinicians.

We aimed to observe changes in fertility indicators in men treated with ablation.

In this prospective cohort study, 18 men with differentiated thyroid cancer from June to December 2020 underwent thyroidectomy plus radioiodine therapy. Participants were grouped based on iodine dose (8 men with 30 mCi vs. 10 men with ≥ 150 mCi). Baseline values (VB) of the follicular stimulating hormone, luteinizing hormone, testosterone, and sperm analyses were measured 3 wk before iodine ablation and repeated 3 (V3) and 12 (V12) months later. They were analyzed once as a whole and once based on their groups via ANOVA and Friedman's tests where appropriate.

The mean age of participants was 35.61 ± 9.74 yr. Follicular stimulating hormone levels showed a significant trend among all participants (VB: 12.51 ± 1.72, V3: 13.54 ± 1.41, and V12: 13.10 ± 1.67 IU/mL; p < 0.001). Luteinizing hormone showed a similar pattern (VB: 4.98 ± 1.27, V3: 5.65 ± 1.29, and V12: 5.21 ± 0.95 IU/mL; p < 0.001). Testosterone levels did not differ significantly from baseline. Sperm count decreased at the first checkpoint and returned to normal after 12 months (VB: 38.22 ± 19.40, V3: 32.05 ± 17.96, and V12: 36.66 ± 18.81 million/mL; p < 0.001). Sperm motility and morphology did not change significantly.

Our research showed that even less than 5 GBq irradiation could induce a transient testicular dysfunction in the first 3 months of therapy, but it was mostly reversible after 12 months.

 Despite the high prevalence of head and neck cancers in Iran, no studies have been conducted to investigate the relationship between vitamin D levels and these cancers. Many Iranians suffer from vitamin D deficiency, which underscores the importance of conducting these studies in Iran.

 This study aims at investigating the relationship between vitamin D levels and laryngeal cancer.

 This 1: 1 matched case-control study included 216 patients in Mashhad, Iran, who had not consumed vitamin D supplements for 3-months before study onset. Participants were grouped in 2 categories; the case group, which consisted of patients with laryngeal cancer whose squamous cell carcinoma was confirmed pathologically for the first time (new cases), and the control group, which consisted of individuals who did not have any cancer at the time of the study, confirmed by indirect laryngoscopy, and were identical to the patient group in terms of other risk factors for laryngeal cancer (smoking and alcohol abuse). First, the relevant checklist (including age, occupation, consumption of tobacco, alcohol use, etc., history of contact with mustard gas, wood, stone, metal, and cement industry, as well as history of reflux in the individual and cancer in relatives) was completed for all case and control group members. After taking blood samples, they were evaluated for serum levels of vitamin D3. Data were analyzed using chi-square, Mann-Whitney U or independent sample t-tests. Logistic regression was also used to determine the relation between vitamin D level and laryngeal cancer.

 Mean age, sex and risk factors of laryngeal cancer were not significantly different between the two groups. Vitamin D level was significantly lower in patients with laryngeal cancer compared to control group (16.02 ± 3.62 ng/mL vs 25.19 ± 3.40 (P < 0.001)). Logistic regression analysis showed that vitamin D level is independently related to laryngeal cancer and has a protective effect on this neoplasm (OR = 0.54, 95%CI: 0.46 - 0.63, P < 0.001).

 A lower vitamin D level may be related to laryngeal cancer. However, the role of vitamin D deficiency as a risk factor for head and neck cancers and whether the treatment of this condition could prevent the incidence of such cancers is a matter of future investigations.

 Laryngoscopy or endotracheal intubation in diabetic patients due to impaired mobility of the Atlanto-occipital joint owing to non-enzymatic glycosylation in connective tissue has always been a problem. A difficult laryngoscopy can disrupt the intubation process; therefore, it is valuable to predict difficult laryngoscopy using some anatomical criteria before general anesthesia.

 The present study discussed the diagnostic value of two tests, palm print sign and prayer sign, in the prediction of laryngoscopy difficulty.

 Design: A diagnostic test and cross-sectional analytical design were used in this study. Setting: The study population included 200 patients with type 2 diabetes who were candidates for surgery under general anesthesia. Before surgery, the patients were examined regarding the airway status, Mallampati classification, head extension rate, thyromental distance, body mass index, upper lip biting test, and two palm print sign and prayer sign tests. All the diagnostic tests were compared to the Cormack test result for difficult airways regarding their sensitivity and specificity in difficult laryngoscopy.

 The highest sensitivity was related to the Mallampati test, prayer sign test, and palm print sign test (100%). Furthermore, the mouth-opening test had the highest specificity (100%). The highest accuracy was reported for Mallampati, palm print sign, and prayer sign tests (> 86%).

 Among the tests studied to predict difficulty in laryngoscopy in diabetic patients, Mallampati and palm print sign tests have good sensitivity, specificity, and accuracy. Studies with a larger sample size are suggested to obtain more accurate results.

Tethered cord syndrome (TCS) is a type of occult spinal dysraphism, which necessitates early detection as an essential component of patient management in reducing complications. This study aimed to compare the findings of spinal cord ultrasonography between TCS patients and healthy individuals.  The current study is a case-control study of patients who were admitted to the Akbar and Ghaem Hospitals (Mashhad, Iran) in 2019. The study population comprised 30 children with TCS aged under two years old, and the control group included 34 healthy peers of the same age. The maximum distance of the spinal cord from the posterior canal wall was measured in millimeters using ultrasonography. Demographic and sonographic findings of each participant were recorded in checklists, which were then entered into SPSS software. P values less than 0.05 were considered statistically significant. The study included 30 children with TCS and 34 healthy individuals with a mean age of 7.67±6.39 months. TCS patients had a significantly shorter maximum distance of the spinal cord from the posterior wall of the spinal canal than the control group (1.75±0.62 mm vs. 2.79±0.76, P<0.001). After performing corrective surgery, the TCS patients indicated significant improvement in this interval (1.57±0.54 mm to 2.95±0.49 mm, respectively, P=0.001). In comparison to children without TCS, the spinal cord was substantially closer to the posterior canal wall in TCS patients. However, these outcomes were improved significantly in patients after surgery.

Platelet transfusion is one of the main treatments for thrombocytopenia to reduce severity and frequency of bleeding. Inadequate increase in platelets following platelet transfusion is known as platelet refractoriness. The aim of this study is to investigate the prevalence, as well as predictive factors, of platelet refractoriness.

In a cross sectional study, 73 patients suffering from severe thrombocytopenia due to leukemia or aplastic anemia, hospitalized at the hematology-oncology ward of two main referral hospitals in Mashhad, were evaluated. Platelet transfusion was done in patients with platelets count less than 10,000 per microliter or less than 20,000 per microliter and fever more than 38° C. Platelet count was measured before and 60 minutes after platelet transfusion, and after calculating body surface area (m2), corrected count increment (CCI) was calculated. If CCI is more than 10,000 per microliter, no platelet refractoriness was considered.

55 patients (75.3%) had platelet refractoriness. Higher platelet refractoriness was seen in the group that received more platelet units and patients who received apheresis units had less refractoriness.

Platelet transfusion should be done only if necessary and transfusion of apheresis units must be considered in patients who need regular platelet transfusion.

Studies have shown that conventional sperm analysis does not represent fertility status completely. About 15% of infertile men have normal clinical and laboratory investigation. DNA fragmentation index (DFI) measures the DNA damage. Also, 20% of men with unexplained infertility have increased DFI level compared to the normal level. The present study was performed with aim to evaluate the clinical utility of DFI as an indicator for varicocelectomy.

This longitude observational study was performed in 2020-2021 on 60 patients who underwent varicocelectomy due to infertility in Imam Reza Hospital of Mashhad. The patients were divided into three groups based on DFI levels (DFI ≤15%, 15-30%, and >30%) considered as excellent, moderate, and poor fertility, respectively. Then, pre- and post-operational semen analysis was performed. Data were analyzed by SPSS software (version 24) and paired-t, Wilcoxon, and analysis of variance tests. P<0.05 was considered statistically significant.

The mean DFI in the excellent fertility group was 10.83 ± 2.92, in the moderate 21.10 ± 6.05, and in the poor fertility 46.56 ± 10.73. The moderate and poor fertility participants experienced statistically significant improvement in sperm count, motility, and morphology. On average, the number of 8.92±16.91 million per cc, the motility of 13.93±19.73% and the morphology of 3.17±3.57% improved after the operation.

The higher the pre-operative DFI, the more significant increase in sperm analysis factors is expected. DFI has a prognostic value for varicocele patients, especially those with higher DFI.People who have a higher pre operative DFI score will improve more after operation.

Fetal exposure to maternal anxiety is associated with low birth weight and maternal stress may be led to constriction of uterine arteries. This study compared the relation of anxiety and uterine artery doppler flow indices in pregnant women with the high and low-risk of Down syndrome. This prospective cohort study was conducted among pregnant women in the second trimester that were classified as having a high or low risk according to their prenatal aneuploidy screening outcome. The high risk group underwent amniocentesis. Anxiety was initially assessed using the Spielberger State-Anxiety Inventory (STAI) and uterine artery blood flow indices were evaluated 2 times for the both groups. For the high-risk group first: immediately before amniocentesis and second: after two weeks follow up, when receiving the karyotype results and for the low-risk group in the first admission and two weeks later. Totally, 375 pregnant women participated in our study that sorted into 2 risk populations based on the aneuploidy screening test, low-risk=176 and high-risk women=199. The high-risk group for Down syndrome amniocentesis showed abnormal results in the 23 cases (23/199). The mean state (P=0.003) and trait (P=0.033) of the Anxiety Inventory scores were significantly different between the groups. Baseline uterine artery indices were no significant difference between the groups. Baseline Uterine artery indices in the high-risk group was significantly different with follow-up (in both positive-amniocentesis and negative amniocentesis sub-groups) indices. Also, there was a weak and significant correlation in the uterine resistance index and STAI scores (P=0.008, r=0.137) during the follow-up period. All pregnant women experienced high level anxiety, especially in the high-risk group that may reduce after confirmation of prenatal aneuploidy screening test and also affects the Doppler indices. For all pregnant women; Stress management and emotional support training is recommended before and during pregnancy.

Various fortification strategies have been proposed to account to treat or prevent vitamin D deficiency. However, the optimum fortification approach, and the effect of these on health is not widely understood. There have been controversial reports regarding the effect of vitamin D fortification on the lipid profile. The aim of present review is the evaluation of administration of vitamin D fortified products on lipid profile. We used databases including PubMed/Medline, ISI Web of Knowledge, Science Direct, Scopus and Cochrane Library. A search was conducted until 2020 Randomized controlled trials that have assessed the relationship between consumption of vitamin D fortified products and serum lipid profile were included. The relationship between fortification dose, dairy or non-dairy fortification as well as duration of intervention and plasma lipid profiles evaluated in separate sub-groups. Among serum lipids including total cholesterol(TC), triglyceride(TG), low density lipoprotein(LDL) and high density lipoprotein(HDL), fortification of vitamin D was reported to have a significant effect on reducing total cholesterol (pooled estimate: -0.089 mmol/L, 95%CI: -0.134 to -0.044, p<0.001). Its effect on other lipid profiles were not significant (LDL pooled estimate:-0.115 mmol/L, 95%CI:-0.238 to 0.008; HDL pooled estimate:0.024 mmol/L, 95%CI:-0.024 to 0.071; TG pooled estimate:-0.176mmol/L, 95%CI:-0.499 to 0.148). This meta-analysis demonstrated that vitamin D fortification could significantly reduce TC both in long and short term interventions and in different products. However this reduction, whilst statistically significant, may not be clinically important. The effect of fortification on other lipid profile components vary depending on dose and duration.

Vitamin D deficiency (VDD) affects more than one billion individuals globally. We aimed to review all the published papers on vitamin D deficiency in  in the country. 

PubMed, Google Scholar, Web of Science, Scopus, Science direct and scientific information databases were searched for papers related to the prevalence of vitamin D insufficiency for all age groups in Iran from 2000 to 2018. The Joanna Briggs Institute prevalence critical appraisal tool was applied for the assessment of the methodological quality of these studies. The Meta-analysis is based on the random effect model using Comprehensive Meta-analysis data analysis.

Eighty-seven original articles reported on participants with vitamin D insufficiency in Iran. According to the meta-analysis of the prevalence of moderately deficient of vitamin D in men and women as well as younger and older individuals (>18 years) using a cut-off point of 25(OH) D3<20 ng/mL was 39% and 51%, respectively. Vitamin D concentrations <30 ng/mL among Iranian populations in the cities of Tehran, Shiraz, Mashhad, and Zahedan were reported to be higher than 90%. The prevalence of vitamin D insufficiency in Iranian women was higher than in men in various age groups. The highest prevalence of vitamin D insufficiency in neonates, children, adults and pregnant women was observed in the Middle East. Most countries had a high prevalence of VDD in elderly people.

Vitamin D insufficiency is common in the Iranian population and is an important public health problem that should be considered seriously.

Chronic pulmonary thromboembolism (CTEPH) is an unusual complication of acute pulmonary embolism (PE), which is now considered to be treatable. In modern multi-detector scanners, a detailed evaluation of pulmonary artery geometry is currently possible. This study aimed to evaluate the changes in pulmonary artery bifurcation angle (PABA) in the follow-up computed tomography angiography (CTA) of patients with acute PE.  In this cross-sectional study, the records of two tertiary-level academic hospitals were gathered from 2012 to 2019. Pulmonary artery (PA) bifurcation angle and diameter were measured. Chi square test, independent samples t test, Mann-Whitney, and Pearson’s tests were employed to compare data. To evaluate the cut-off point, we utilized receiver operating characteristic (ROC) curve analysis. The accuracy, sensitivity, and specificity of pulmonary artery bifurcation angle changes were calculated. A P value <0.05 was considered to be significant.  Forty-six patients were included in the study. No significant differences were found between patients with and without CTEPH, and PABA in the dimeters of PA trunk, right PA, and left PA in the first CTA images (P values of 0.151, 0.142, 0.891, and 0.483, respectively), while in the secondary CTA, the mean PABA was significantly smaller in patients with CTEPH (P=0.011). In the receiver operating characteristic (ROC) analysis, delta angle revealed an area under the curve of 0.745 and an optimal cutoff of 0, leading to a sensitivity of 64%, specificity of 87%, and accuracy of 76% for diagnosing CTEPH. We showed a significant decrease in PABA in patients developing CTEPH. This parameter can be easily measured in lung CTA.

The immediate impacts of coronavirus disease 2019 (COVID-19) on mental health of affected patients and psychiatric morbidities of these patients has been neglected by researchers. We assessed mental health outcomes and sleep status among inpatients and outpatients with COVID-19 who were initially referred to our COVID-19 clinic in Mashhad, Iran during April-October 2020.

In this ethically approved cross-sectional study, 130 patients with confirmed COVID-19 who were referred to outpatient clinics and wards of a referral hospital in Mashhad, Iran were surveyed during April-October 2020. Demographic data were collected after obtaining informed written consent. Validated Persian versions of insomnia severity index (ISI), 9-item patient health questionnaire (PHQ-9), and 7-item generalized anxiety disorder (GAD-7) and revised impact of event scale (IES-R) were used as main outcome measures (i.e. status of anxiety, depression, insomnia, and event-related distress). Analysis was performed with SPSS using binary logistic regression. P-values < 0.05 were considered significant.

Overall, 65 inpatients and 65 outpatients were surveyed. The two groups did not significantly defer in terms of insomnia and depression severity, but the outpatients showed higher levels of anxiety (52.3% vs. 24.6%, P = 0.005) and distress compared to inpatients (80.0% vs. 64.6%, P < 0.001). Male sex (OR = 0.017, 95%CI = 0.000-0.708, P = 0.032) exhibited independent and inverse association with depression in COVID-19 patients. Being married (OR = 0.102, 95% CI = 0.018-0.567, P = 0.009) was independently and inversely associated with anxiety. Insomnia was independently associated with event-related distress (OR = 7.286, 95%CI = 2.017-26.321, P = 0.002). Only depression was independently associated with insomnia (OR = 49.655, 95%CI = 2.870-859.127, P = 0.007).

We found symptoms of psychological distress and anxiety to be more prevalent among outpatients with COVD-19 than inpatients. Insomnia can be a potential risk factor for adverse mental health outcomes in these patients.

Coronavirus disease 2019 (COVID-19) may lead to myocardial damage and arrhythmia. Patients with ECG changes have shown an increased risk of mortality.

We aimed to study the changes in the electrocardiogram, which may be of great significance for risk stratification of COVID-19-positive patients.

A retrospective study was conducted to compare electrocardiogram changes and disease severity markers in COVID-19-positive patients admitted to a referral hospital between February 20 and March 20, 2020.

Our study consisted of 201 cases, including 123 males and 78 females. Ages ranged between 16 and 97 years old. Fifty-two (25.9%) cases had a history of ICU admission. Multivariate logistic regression analysis showed that a low O2 saturation level (OR = 0.920, 95% CI 0.868–0.976, p=0.005), several lab tests, ECG changes (OR = 46.84, 95% CI 3.876– 566.287, p = .002) and Age (OR = 1.03, 95% CI 1.000– 1.065, p = .048) were the independent risk factors for predicting mortality rate. In addition, we utilized multivariate logistic regression analysis, demonstrating that LBBB (OR = 4.601, 95%CI: 1.357–15.600, p=0.014) is the only ECG risk factor associated with morbidity in elderly patients with ECG changes.

ECG changes are strong indicators of high mortality rates in elderly COVID-19 patients. ECG interpretations should therefore be used for risk stratification and predicting the need for ICU admission.

Considering the psychobiological aspects of various dermatological diseases and the role of personality traits in the development of chronic skin diseases such as chronic urticaria, the present study aimed to assess the personality traits of patients with chronic spontaneous urticaria (CSU) compared to healthy individuals.

In this cross-sectional study during 2016 - 2018, all patients with CSU who referred to Immunology and Allergy Clinic of Ghaem hospital, the Center of reference and excellence in urticaria (UCARE), considered as research community; 100 patients with CSU were selected using the convenience sampling method. Moreover, 100 healthy participants were selected as the control group. Research instruments were Temperament and Character Inventory (TCI) and a demographic checklist. Data were analyzed using descriptive statistics, t-test, and chi-square test using SPSS Software version 23.

The patients had higher scores in novelty-seeking (P = 0.041) and harm avoidance (P = 0.015), while the healthy individuals had higher scores in self-directedness (P = 0.003) and cooperativeness (P = 0.001). Moreover, male patients had higher scores in novelty-seeking (P = 0.006) and reward dependence (P = 0.013); however, female patients had higher scores in self-transcendence (P = 0.001) and cooperativeness (P = 0.019). Furthermore, there was a correlation between the disease duration of with reward dependence, self-directedness, and self-transcendence.

Personality traits seem to be associated with CSU. In this regard, patients with CSU had higher scores in novelty-seeking and harm avoidance and lower scores in self-directedness and cooperativeness than healthy individuals.

Vitamin D plays an essential role in the regulation of bone metabolism. The current meta-analysis aimed to assess the effectiveness of vitamin D fortification on special bone biomarkers.

Five main databases (PubMed/Medline, ISI Web of Knowledge, Science Direct, Scopus, Cochrane Library as well as Science Direct, and Scopus) were considered for this systematic review, until Jan 2020. All randomized controlled trials were included to evaluate the probable relationship between consumption of vitamin D fortification products and bone biomarkers profile in this review.

Among serum bone biomarkers (osteocalcin and telopeptides of type-1 collagen) investigated, only the level of telopeptides of type-1 collagen significantly decreased after fortification of vitamin D in the intervention group. A significant increase in vitamin D was seen in those older than 18 yr old, while the increase in younger children was not statistically significant between intervention and control groups.

Vitamin D fortification was not associated with a significant improvement in bone mass density (BMD), while it resulted in decreased PTH levels. Vitamin D fortified foods have some benefits on bone health due to increase in the level of vitamin D and IGF-1; and decreasing PTH and CTx levels.

Premature ventricular contractions (PVCs) are early depolarizations of the myocardium which originate from the ventricle. PVCs have previously been considered a benign condition. The clinical significance of PVCs in patients without structural heart disease is controversial.

In this cross-sectional study, patients with a palpitation complaint who underwent electrocardiography (ECG) Holter recording for 48 hours were analyzed. Patients with frequent PVCs (more than ten times in 1 hour) were identified and enrolled in the study. 26 patients were in the PVC group, and 26 patients were in the control group without PVC. The identified patients underwent an echocardiographic examination with strain modality.

There were 15 women (57.7%) in the PVC group and 17 women (65.4%) in the control group (P = 0.57). Two patients in the PVC group and three patients in the control group were hypertensive (P > 0.99). There was only one patient with diabetes in PVC and control group (P > 0.99). There were two smokers in the PVC group, whereas there was no smoker in the control group (P = 0.49). In comparison between two groups, patients with frequent PVCs had significantly larger left ventricular end-diastolic volume index (LVEDVI) (P = 0.048) along with lower left ventricular ejection fraction (LVEF) (P = 0.011), lower (more positive) left ventricular global longitudinal strain (LVGLS) (P = 0.001), and lower peak systolic mitral annular velocity (S') (P = 0.045). The left atrial volume index (LAVI) was significantly larger in the PVC group (P = 0.001). In speckle tracking echocardiography (STE) parameters, global peak atrial longitudinal strain (PALS) (P = 0.001) and peak atrial contraction strain (PACS) (P = 0.001) were significantly lower and time to peak longitudinal strain (TPLS) (P = 0.002) was significantly higher in the PVC group.

In this study, left atrial (LA) and left ventricular (LV) function and geometry were adversely affected by frequent PVCs. Early diagnosis of these effects is possible with echocardiography along with strain analysis. It can guide the timely treatment of PVC to avoid the harmful effects of frequent PVCs on the heart.

We aimed to assess the efficacy of Intraprostatic Onabotulinumtoxin-A (BTA) on the International Prostate Symptom Score (IPSS) and other objective measures of patients with Benign Prostatic Hyperplasia (BPH).

Fifteen patients were included in this study. The drug (BTA; 150 IU) was reconstituted in 20 mL of 0.9% saline before administration to the patients. After providing urethral anesthesia, 20 intraurethral injections were made to lateral lobes of the prostate, 10 injections in each lobe. Follow-up visits were planned 3 and 12 months after the intervention. Pre- and post-interventional IPSS, Prostate-Specific Antigen (PSA), Prostate Volume (PV), Post-Void Residue (PVR), and maximum urinary flow rate (Qmax) compared via paired t-test. Finally, we reviewed the Pubmed database to provide a more precise conclusion.

The Mean±SD age of patients was 69±8.24 years, and the mean IPSS score decreased significantly from 24.3±3.3 to 14.6±3.7 (p<0.001) and 16.86±3.06 (p<0.009) on the 3rd and 12th months, respectively. The Mean±SD PSA, PVR, Qmax, and PV were 3.26±1.38, 82.33±35.55, 8.56±1.76, and 47.86±8.93, respectively at baseline. These factors significantly improved to 2.72±1.33 (P<0.000), 71.33±30.55 (p<0.000), 9.5±1.33 (p<0.011), and 42.86± 6.04 (p<0.000), respectively, on the 12th month follow-up.

Although the overall results support the efficacy of BTA for BPH, the best route of administration, the most effective dose, the optimal number, and the volume of injections need further investigations. The probable placebo effect and underlying medical conditions (e.g., insulin resistance) should be considered as the confounding factors.

Oral health literacy (OHL) is a type of health literacy that specifically focuses on people`s literacy and knowledge about oral health. It has been shown that oral health literacy can be a powerful predictor of people's health, health-related behaviors, and medical outcomes. As parents play a crucial role in their child`s health, in this study we aimed to assess the oral health literacy of the adults and its relation with their children`s dental status.

Four hundred parents with their children participated in this cross-sectional study. Two hundred OHL questionnaires were distributed to parents of 3–6-year-old patients referred to pediatric hospitals for any reason. The OHL was assessed in three domains: reading comprehension, numeracy and appropriate decision-making. The score were categorized as inadequate, 0-7; marginal, 8-9, and adequate, 10-15. Then a dentist did the dental examination of their children, and the DMFT (decay-missing-filled teeth) index was calculated. Chi-square, independent sample t-test, Mann-Whitney, and Kruskal-Wallis tests were used for comparative analysis.

69.2%, 21.2% and 9.6% of the parents had inadequate, marginal and adequate OHL, respectively. The mean DMFT was 4.5±4.47 (median:3) with minimum of 0 and maximum of 17. The mean age of parents and children did not differ between 3 groups of OHL, but DMFT was significantly higher in participant with inadequate OHL (p=0.03). The mean DMFT was also higher in families with greater than four family members(p=0.002). It is shown that the frequency of inadequate OHL was higher among parents with lower education(p=0.002), while the DMFT did not differ in 3 groups of education(p=0.84).

Parents with inadequate OHL was associated with high children’s dental caries. So, conducting oral health education for parents is essential. Holding training classes in health centers can improve the parent’s oral health literacy, and hopefully motivate them to look after their child’s dental health.