marzieh rohani rasaf

Knowing the level of awareness, attitude, and performance of people is an important step in leishmaniasis prevention. This study aimed to investigate the knowledge, attitude, and practice of people in Damghan district about cutaneous leishmaniasis in 2018-2020.

In this cross-sectional descriptive study, for 500 people living in urban and rural areas, a semi-structured researcher-made questionnaire approved for content validity and reliability was randomly completed by a trained questionnaire and information was recorded and analyzed using SPSS21 software.

The mean age of the subjects was 37.7, and 52.6% of them were in the age group of 20-40 years. 55% of people had poor knowledge, and 61% and 65% had moderate attitudes and performance, respectively. 97.2%, 72%, and 32.4% of the subjects did not know the agent, reservoir, and symptoms of the disease, respectively. To prevent the disease; 44.6% of people did not take any action, 54.2% installed nets on doors and windows, and also 28.5%, 40.2%, and 25.3%, respectively, always used mosquito nets, insecticide sprays, and insect repellent ointments.

Despite being the disease endemic in the region, the level of knowledge, attitude, and practice of the people was weak to moderate. Therefore, raising the KAP levels of the county's people about leishmaniasis is highly recommended.

High prevalence of diabetes mellitus (DM) makes it an important comorbidity in patients with coronavirus disease (COVID-19). The objective of the current study was to compare morbidity and mortality between patients with diabetes and controls.

This cross-sectional study was conducted in Imam Hossein hospital of Shahroud. A total of 184 patients with confirmed COVID-19 were included. Individuals with chronic underlying diseases such as cardiovascular diseases, hypertension, and pulmonary diseases were excluded. Then, patients were divided into two groups: patients with COVID-19 who also had DM, and individuals with COVID-19 who did not have a history of DM.

The prevalence of high diastolic blood pressure (DBP) and fever were significantly more in the non-diabetes patients (prevalence DBP=10%, p value=0.05/ prevalence fever=65%, p value=0.01). Also, the mortality rate was slightly higher in non-DM patients (P =0.5). There was not any statistically significant difference between other clinical features and laboratory tests between the groups.

We found that DM patients with COVID-19 infection were not at a higher risk of mortality or poor outcome compared to the non-DM patients.

People with asthma are generally more susceptible to respiratory infections than the general population. As a result, patients with asthma are presumed to be at a higher risk of COVID-19 and health complications during the current pandemic. However, the relationship between asthma and COVID-19 remains unclear.

This cross-sectional study was done in Imam Hossein hospital of Shahroud. Considering the prevalence of 4.7% of asthma in Iran , the confidence interval of 95% and the power of 80%, 93 patients were entered in the study.. Based on pre-existing asthma, the study population was divided into two groups; the COVID-19 patients with asthma and the COVID-19 patients without asthma. Lastly, the study compared the groups in terms of clinical course and laboratory findings. Patients with a history of smoking, diabetes, cardiovascular disease, COPD, and hypertension were excluded from the study.

Among 93 COVID-19 patients, mean lymphocyte count (mean±SD=2.1±1.1, p-value=0.001) and serum glutamic oxaloacetic transaminase (SGOT) level (mean±SD=34.3±19.5, p-value=0.001) were higher in the patients without asthma. By contrast, asthma patients had a higher prevalence of heart rate disorders (27%, p value=0.04 ), positive C-reactive protein (CRP) results (40%, p value=0.0001). Also, a significantly higher frequency of high diastolic blood pressure (DBP) was present in the asthma group (p-value= 0.02). Other variables did not show any significant association.

Patients with mild to moderate asthma were not significantly different from non-asthmatic patients in terms of severity of the disease.

Covid-19 was first reported as a viral disease in China in 2019, and it soon became a global pandemic. In addition, the types of occupations people have and the environments in which they work may increase the likelihood of being exposed to the virus. Thus, this study was conducted to investigate the prevalence of Covid-19 disease in various occupations and its relationship with some effective parameters in Shahroud city.

This research is a cross-sectional, descriptive-analytical study that was conducted in 2021. The required information was extracted from the database provided by Shahroud University of Medical Sciences. These files contain the results of the comprehensive study of COVID-19 in Shahroud. All the jobs that were asked of the person were classified based on International Standard Classification of Occupations and suspicious and definite cases were examined in different occupation. The information analyzed using SPSS software version 22.

According to the results, the highest percentage of cases (45%) was in healthcare workers, such as doctors, nurses, and operating room staffs—in other words, all employees working in the healthcare system. The next highest percentages were in household and home nursing workers (44.5%), retirees (43.2%), and construction workers (43%). The relationship between variables such as age, smoking status, presence of comorbidities, and presence of a high body mass index (BMI) associated with Covid-19 disease was examined by the regression test. It was found that the relationship was significant, that these variables affected the prevalence of the disease. Based on the odds ratio in the age variable, with each year of age, the chance of getting infected increased by 1%. A current smoker had a reduced chance of getting the disease by 57.2%. Having a comorbidity increased the chance of getting the disease by 14%, and with each increase in BMI, the chance of getting the disease increased by 3.8%.

The study found that in some occupations, such as healthcare worker, the prevalence of the disease was higher because workers were in direct contact with patients and people infected with the virus. In general, it can be said that the prevalence of the disease was low in workers who could telework and remain at home rather than go to a job or in the community. Factors such as age, the presence of comorbidities, status as a current smoker, and having a high BMI had an effect on contracting Covid-19 disease.

This case study includes three pregnant women with COVID-19 diagnosed during pregnancy or delivery between March 28 and May 13, 2020. All cases were confirmed by a positive pharyngeal reverse transcription polymerase chain reaction (RT-PCR) test and one case by computed tomography scan (CT Scan) in addition to the (RT-PCR). Clinical and laboratory information was extracted from hospital records during pregnancy and delivery. The adverse effects during pregnancy and after the birth of the newborn, the possibility of vertical transmission from positive pregnant mothers to the neonates were investigated. Of the three women with COVID-19 infection, one patient was diagnosed two weeks before delivery and two were diagnosed during delivery and hospitalization. No adverse effects including preeclampsia, gestational hypertension, rupture of the amniotic sac during pregnancy and premature delivery were observed but one of the patients suffered from intrauterine fetal death (IUFD). in this study,  adverse pregnancy outcome was not observed in  pregnant women with Covid-19  infection  based on hospital observations. No vertical transmission was observed following vaginal delivery or cesarean section and during pregnancy. As the effect of the virus on different people in society varies according to their individual characteristics, our conclusion in this study on pregnant women is also affected by these individual differences, which requires further studies in this field with more samples.

 COVID-19 is a serious disease with different symptoms and risk factors infecting and killing many people around the world. This study was performed to investigate the demographic and clinical characteristics of COVID-19 suspects referred to the hospitals and coronavirus treatment centers of Shahroud, Iran.

 Upon the outbreak of the COVID-19 epidemic in Shahroud, Shahroud University of Medical Sciences launched a project to systematically record the demographic, clinical, and medical data of all suspects referred to the Corona Center. In this study, the data of 3945 suspected people collected during 5 months were analyzed. The RT-PCR test was used as the criterion for diagnosing the disease.

 Among 3945 suspected cases, 24.4% had positive RT-PCR test. The mean age of confirmed cases was 52.16 years. Dry cough and fever in addition to anorexia were reported as the most common symptoms. The results of logistic regression analysis showed that people over 60 years with heart disease reduce the risk, while people over 60 years, diabetics, and obese people increase the risk of infection.

 These results necessitate further lines of research into different symptoms and risk factors to help identify COVID-19 cases earlier and start faster treatment.

The effect of related factors on recovery or death rates may vary from country to country. There-fore, we aimed to investigate the relationship between demographic, clinical, laboratory factors on the survival rates of confirmed cases of COVID-19 in Shahroud, Iran.

This is an analytical study of the estimation of the survival of patients with COVID-19. Patients who had positive PCR test were considered as COVID-19 cases, and the 2-month survival of these patients was esti-mated. Among the diseases, heart disease and diabetes were considered as separate variables, and the patients' histories of other diseases were included in the model as comorbidities.

Of 396 confirmed patients hospitalized, 109 patients (27.5%) had a history of heart disease, 100 (25.3%) were diabetic, and 80 (20.2%) had a history of other comorbidities. The number of deaths due to the disease was 59 (14.9%). The median age of those who died was 76 years. The multivariate Cox regression analysis shows that heart disease increases hazard ratio more than two times (HR=2.37, 95% CI: 1.33-4.23). The neutrophil-to-lym-phocyte ratio (NLR) factor, (HR=1.15, 95% 1.08-1.22),and older age (HR=1.06, 95% CI: 1.03-1.08)increases the risk of death significantly.

The heart disease history, NLR factor andolder age are associated with death of COVID-19 and may be helpful for the early warning and prediction of disease progression.

The COVID-19 pandemic has been a serious health problem in most countries in the last few months, with every country adopting different preventive and therapeutic measures based on their specific circumstances. The epidemic began in Iran on February 19, 2020, and gradually spread across the country. The epidemic extent varies, and different preventive and therapeutic measures are taken in Iran. Shahroud and Miami Counties, covered by the Shahroud University of Medical Sciences, have experienced the highest incidence of COVID-19 in Iran. However, the epidemic is well controlled by integrating the activities of the health, treatment, and research sectors and using information technology and a proprietary software application. This model can be thus studied as a successful experience.

Since the Covid-19 pandemic, research has focused on identifying people at risk and preventing its spread. The aim of this study was to investigate the relationship between blood groups (ABO) and the risk of COVID-19 infection in Shahroud.

This study is an analytical cross-sectional study. Data from suspected cases of Covid-19 were collected in Shahroud by the Corona Registration System from the beginning of the epidemic in February 2020. In this study, confirmed cases of Covid-19 were defined as those that had a positive RT-PCR test. Logistic regression was used in order to investigate the relationship between ABO and COVID-19 infection, and other variables, such as co-morbidities, age, and gender also were adjusted.

In this study, the highest percentage of positive PCR was for B type (49.6%) and then AB (43.1%), but this difference was not significant. In the modeling, a significant relationship was observed between B type and Covid-19 infection, so that the risk is 56% higher. Also, in the study of the relationship between non-O blood groups and adjusted for the variables of age, gender, and comorbidities, it was shown that non-O blood type compared to O blood type increased the odds of infection by35% significantly. Rh did not show a significant association with infection.

This study showed that non-O blood types have higher odds of developing Covid-19 compared to the O blood type. Among the various blood types, type B increases the odds of infection by 56%.

Coronavirus disease 2019 (COVID-19) is a coronavirus outbreak caused by severe acute respiratory syndrome coronavirus 2 infection.

This study aimed to investigate the relationship between laboratory variables and COVID-19 severity.

A total of 731 confirmed cases were included in this study. Based on the clinical course of the disease, the patients were divided into non-severe (n = 599) and severe (n = 132) groups. The area under the curve was estimated for each of the significant predictive factors by the receiver operating characteristic curve. Youden’s index was used to determine the optimal cut-off points to predict the severity of COVID-19.

Out of 731 patients, 407 (55.56%) cases were male. The mean age value and age range of the patients were 58.37 and 1 - 98 years, respectively. The age (OR = 1.03, 95% CI: 1.02 - 1.05), international normalized ratio (INR) (OR = 2.09, 95% CI: 1.11 - 3.96), lactate dehydrogenase (LDH) (OR = 1.003, 95% CI: 1.001 - 1.1.003), and neutrophil/lymphocyte ratio (NLR) (OR = 1.08, 95% CI: 1.02 - 1.14) were associated with the severity of COVID-19 in the multivariate analyses. The areas under the curve of LDH, NLR, and INR for the diagnosis of disease severity were 0.76, 0.69, and 0.62, respectively.

The results of this study revealed that LDH, NLR, and INR could help to discriminate between non-severe and severe COVID-19 cases. Therefore, clinicians can use these variables to improve therapeutic effects and reduce disease severity.

Serial interval refers to the average time between of the onset of the symptoms of two successive cases. Serial interval distribution can be used for the calculation of the basic reproduction number (R0), transmission rate, and study of an epidemic trend. This study aims to investigate the mean, standard deviation, and distribution of serial interval among the confirmed cases of COVID-19 using a Gamma distribution.

To determine the serial interval, 60 confirmed infected cases of COVID-19 (based on PCR test results) in February 20th-May 20th, 2020 were selected as the cases. For these cases, 37 transmissions occurred. The data of the dates of the occurrence of primary and secondary symptoms were collected by referring to the COVID-19 surveillance system and interviewing the patients

The findings showed that the median and mean of the serial interval were 3.0 and 4.5±3.5 days. The findings showed that the median of the serial interval was 3.0 days (with the inter-quartile range of 2.0-6.0). The mean serial interval was 4.5±3.5 days (95% confidence interval: 3.1-5.5).

Our report showed a shorter period for a serial interval less than the previous reported interval in China. It seems that regarding the shorter serial interval reported in this study, the basic reproduction numbers reported by the first papers published in Iran have been overestimated regarding the serial interval of 7.5 days.

 The outbreak of Coronavirus Disease 2019 (COVID-19) has influenced all age groups; however, the risk of mortality increases with age. Several factors impact the development of this disease. This study aimed to determine the relationship between some risk factors in the development of COVID-19 among community dwellers of ≥50 years of age.This cross-sectional study was performed at Shahroud University of Medical Sciences from April 1, 2019, to June 20, 2020. 

Methods & Materials:

 This cross-sectional study was conducted on individuals aged ≥50 years, including middle-aged and aging suspected of COVID-19 referring to registration centers in Shahroud University of Medical Sciences from Feb. 20th to Jun. 20th, 2020. The basis for diagnosing COVID-19 in suspected cases was a positive Reverse Transcription Polymerase Chain Reaction (RT-PCR) test based on a nasopharyngeal swab or Computed Tomography (CT) scan. The data used included demographic information, a history of smoking, and comorbidities. Data analysis was performed in SPSS by descriptive statistics, Chi-squared test, Independent Samples t-test, and logistic regression model.

 In the first 4 months of the COVID-19 outbreak, 3945 suspicious cases were referred to Shahroud healthcare centers. After removing the missing cases, of the 3119 registered cases, 1348 participants were aged ≥50 years. Of all eligible participants, 602 cases were diagnosed with COVID-19, and 303 were males. The obtained data suggested that the Mean±SD age of the study subjects was 66.62±11.33 years. Diabetes (P=0.014) and other comorbidities, such as asthma, acute respiratory, hepatic and kidney diseases, and cancer in borderline significantly increased the incidence of COVID-19 by 38% and 32%, respectively. An increase of one unit in Body Mass Index (BMI) (P=0.002) enhanced the odds of infection by 4%.

 Based on the multivariate logistic regression results, high BMI and diabetes were significant risk factors in the development of COVID-19 among aged subjects. This conclusion emphasizes the importance of BMI and diabetes in the assessment of patients in middle-aged and aging groups.

Cancer is a major public health concern all over the world. The aim of the current study is to demonstrate changing trends of cancer incidence from 2006 to 2009 in Tehran (capital city of Iran) and evaluate the effect of living in different regions according to their median socioeconomic status (SES) on cancer cumulative incidence.
The incident cases were obtained from the population based cancer register of ministry of health and medicine in Iran; we examined the annual percent changes (APCs) and overall trends of total cancer incidence across regions in Tehran. The age and sex standardized incidence rates were computed by the direct method. Poisson regression and negative binominal regression model were used to assess the existence of trends across 4 consecutive years, as well as the effect of living in each region, literacy rate, and employment rate across regions on this trend. All the analyses were done by Stata 12.0 software.
The findings of this study showed downward and nonlinear trend during 4 years. The age-standardized incidence rate (ASR) was higher in men compared to women in this period. ASRs for overall 4 years were 114 and 101 per 10,0000 men and women, respectively. Average annual percent change based on ASR and regression model for each sex was the same and around -5% and -6%, respectively. Incidence rate also differed between districts so that north and center districts had higher incidence than southern parts in both sexes. The lowest rate ratio attributed to district 17 and 18 located in south of Tehran and the highest rate ratio attributed to district 6 for each sex compared to the baseline district 16. Results reported the sharp increase of 59% and 37% in district 6 compared to district 16 in men and women, respectively. Better regional social status increased the risk of cancer among women. Also, the results showed a partially significant interaction with higher decrease in annual trend of cancer rate in socially more deprived regions.
The results showed downward and nonlinear decreasing trend during 4 years, especially in regions with lower socioeconomic status. Incidence rate also differed between districts so that northern regions had higher incidence than southern regions. Spatio-temporal Analysis of these cancer rates with adjustment for more regional socio-economic characteristics may better explain the disparities in rate of cancer in different districts across time.

The number of new cancer cases in the elderly is growing because of the aging population.
Cancer data of the elderly (65 years and older) were collected from Iran cancer registry in 2007. Local Moran’s I was used as a measure of spatial analysis to identify the cluster patterns.
The overall cancer incidence rates were 862.4 and 474.8 per 100,000 in men and women, respectively. Prostate cancer and breast cancer were the most common types of cancer in men and women, correspondingly. Using the Local Moran’s I tool, we identified more spatial clusters among men than women. Districts 1, 2, 3 and 6 in the north of Tehran were hot spots for prostate cancer and district 16 in the south of Tehran was the cool spot for this type of cancer, and districts 1 and 3 were the hot spots for breast cancer.
More cancer hot spots were located in the north of Tehran where districts are more privileged, and more cool spots were located in the south of the city where districts are more underprivileged.

Breast cancer treatment success depends upon prolonging survival with effective treatment, and constant monitoring of recurrence. Survival rate can well be improved by better understanding of prognostic factors, preventive measures, and effective treatments together with follow-up and post-treatment care.
This study is aimed to know prognostic factors effective in recurrence and death in Iranian breast cancer patients.
This is a retrospective study conducted by reviewing data acquired from 1604 female breast cancer patients who were admitted to Cancer Research Center at Shahid Beheshti University of Medical Sciences between October, 1982 and March, 2014. During the follow-up, after diagnosis, 313 patients experienced recurrence then were classified into two groups: early recurrence, less than 1 year and late recurrence after 5 years. We analyzed prognostic factors of recurrence in each groups and evaluated effective factors of death in this patients.
Median age of patients at diagnosis was 50 years. Median follow up time was 4.33 years (range: 0.005-24.9 years). Of these patients, 210 (67.09 %) and 76 (24.28%), developed distant and loco -regional recurrence. Among 313 patients, 62 (21/60%) and 69 (24/04%) had early and late recurrence. In the univariate analysis, tumor grade, stage of disease, ER and PR status, axillary lymph node involvement and lymph vascular invasion were the prognostic factors affecting recurrence in patients, but in the multivariate analysis, ER/PR status was the most important independent prognostic factor affecting the early recurrence and stage of disease were prognostic factors in late recurrence. In all of the recurrent patients, 56.86% (178 individuals) survived and 43.13% (135 individuals) died at the end of follow-up period. The most important factors of death were histologic grade, disease free survival time, site of recurrence and age of disease.
Biologic marker, estrogen and progesterone receptors status, had most influence in early recurrence, unlike late recurrence, stage of disease had a more important role. However, lymph vascular invasion has been an effective factor either in early or late recurrence. As a result of studying effective factors in death of these patients, recurrence site, DFS, pathologic grade and patients’ age at the time of recurrence came to be effective. Knowing more about affecting factors on recurrence and the death of patients with recurrence, one can try to enhance survival and quality of life in patients by adopting more effective treatments.

The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking and various environmental factors. A variety of cancers data in special geographic areas can help define medical programs for treatment and screening of high-risk groups. Since cancer types has not been reported within districts and neighbourhoods of Tehran city so far, this study could be considered as the first in this respect, which defines cancer epidemiology in the catchment area, and on the other hand, paves the provision of equitable services patient who need these facilities.

This is the cross sectional study that shows cancer distribution patern. Incident cases from Tehran residents covered by the Iran University of Medical Sciences were obtained, which included almost 55% of the total cancer incidence in Tehran in 2007. Districts covered by the university were located in west and southwest of Tehran including districts 2,5,6,9,18,21, and 22 cases of other districts refered to Iran university that identified incidence cancer but results must interpreted with caution since those resident districts have not been covered population data were obtained from theprevious census in 2006. Age and sex standard rate were calculated based on Iranian standard population. Cancers distribution maps were developed using available adresses, indicating districts and neighbourhoods in GIS. Common cancers diffrence within covered districts was tested by Fisher exact test.

Cancer incidence in specified districts of Tehran was 72.822 in 100000 population, where district 6 had the highest incidence (ASR=90.552) followed by district 2 (ASR=71.503) and the least incidence was in district 18 (ASR=34.991). This diffrence was significant within districts by Fisher exact test. The highest ASRs in women was 87.517 in districts 6 and 2 (71.621) and in male respectivly 94.683 and 70.919. Highest incidence within neighbourhoods were Abasabad, Qaemmaqam and Gand in males and Ddaneshgah, Arjantin and Shiraz in females. High cancers ASR consisted of breast (9.018), colorectal (4.94), prostate (4.174), stomach (3.711) and skin (3.522).

More cancer aggregation, which was observed in districts 2 and 6 within the university catchment area and districts 1 and 3 out of this territory, warrants more researches to investigate what factors in the specified districts and neighbourhoods has led to this condition.