seyed saeed hashemi nazari

 COVID-19 is a viral disease caused by the SARS-CoV-2, leading to several variants. This study aimed to examine the effectiveness of booster doses against the Delta and Omicron variants over different follow-up times.

Study Design:

 This was a longitudinal meta-analysis.

 Searches were performed in PubMed, Cochrane Library, Scopus, and Web of Science databases, and eighty studies were selected for investigation. The analyses were separately performed on the unvaccinated control group (UNVCG) and the complete two doses of the vaccine control group (C2DCG) against Delta and Omicron variants. Three outcomes were examined, including symptomatic infection, hospitalization, and death.

 Vaccine effectiveness (VE) in UNVCG studies for symptomatic infection revealed a non-linear trend against Omicron with a peak of 67.3%, declining to 27.1% after 25 weeks after a booster dose. The mean of VE for hospitalization over time started to decrease after four weeks against Omicron and after eight weeks against Delta. The VE reached a peak at week eight (96.0%) and started to decline with a VE of 93.3% after 20 weeks after the booster dose against Delta. It was 90.8% at week four and decreased to 73.4% after 25 weeks after the booster dose against Omicron. VE in the C2DCG studies demonstrated more decreases in outcomes over time.

 Our findings showed a tendency to decrease effectiveness over time based on outcomes and variants. The early protection levels were lower in Omicron. Moreover, the VE decrease over time was stronger in Omicron compared to the Delta variant.

The current registry system aims to design a database that can be used for future research as a tool to produce and update new protocols for the diagnosis, treatment, management, and prevention of heart diseases.  

In this hospital-based registry system, established on 27 July 2021, all the adult patients (age ≥18 years old) with signs and symptoms of cardiac diseases under coronary angiography or angioplasty in the cardiac ward of Imam Hossein Hospital of Tehran, Iran were recruited and followed-up until 30 days after discharge in the pilot phase. All data were collected using a researcher-made checklist from face-to-face interviews with patients and their medical records. The data were registered electronically in web-based software. Quality Control (QC) is conducted monthly by the QC team to ensure the documented data's quality.  

among 1265 patients under coronary angiography or angioplasty over a year, 97% (n=1198) of them were Iranian, and 991 (73.33%) patients lived in the country's capital, Tehran. About 55% (n=706) of patients were male. The mean age of the total patients was 60.48 ± 12.01 years. 764 (60.39%) patients were diagnosed with Coronary Artery Disease (CAD). Of all CAD patients, 32.72% (n=250) and 1.18% (n=9) were premature and very early CAD, respectively. During one year, 22.54% (n=279) and 7.02% (n=87) of patients were under PCI and CABG, respectively.  

Since CVDs, especially CADs, are one of the most common and priority diseases in Iran's health system, establishing a coronary angiography and angioplasty registration system is an opportunity to study the epidemiological and clinical process of CVDs in the shape of an accurate registration system.

Type 1 diabetes mellitus (T1DM) is a prevalent chronic disease among children and adolescents, necessitating effective self-monitoring of blood glucose (SMBG) levels. Understanding the determinants and factors influencing SMBG behavior is crucial for optimizing diabetes management in this population.

This study aimed to investigate the frequency of SMBG and identify the determinants influencing factors in children and adolescents with T1DM.

This cross-sectional study was conducted in Tehran, Iran, and included 275 participants selected through simple random sampling from the Gabric Diabetes Education Association. The inclusion criteria comprised children and adolescents aged 3 - 18 years diagnosed with T1DM for at least 6 months who were using analog or neutral protamine Hagedorn (NPH) and regular insulin subcutaneously. Patients using insulin pumps were excluded. Data collection involved an online questionnaire covering demographic information (e.g., age, gender, educational status, and parental occupations) as well as clinical information (number of hypoglycemic episodes, hemoglobin A1C (HbA1C) levels, diabetes duration, insulin regimen, diabetes complications, glucose monitoring practices, hospitalizations, and behavioral characteristics). Statistical analyses, including descriptive statistics, correlation tests, and Poisson regressions, were performed using SPSS software (version 21). A significance level of P-value < 0.05 was considered statistically significant.

The participants had a mean age of 10.00 ± 3.77 years, with 54.2% being males. Most of the participants (87.3%) were students, and the mean age of diagnosis was 6.56 ± 3.73 years, with a mean duration of 44.72 ± 36.32 months. Anthropometric investigations revealed mean height, weight, and body mass index (BMI) values of 136.69 ± 21.11 cm, 37.45 ± 15.51 kg, and 18.31 ± 3.55 kg/m2, respectively. The majority of participants (93.5%) used insulin pens, and the mean daily insulin dosage was 35.34 ± 22.20 IU. Parents reported consistent glucose level monitoring in 64.7% of cases. The mean HbA1c level was 7.91 ± 1.58%. Factors such as the price and availability of glucometer strips influenced glucose level monitoring. In univariate analysis, only age and HbA1C levels showed a negative correlation; however, parents’ consistent checking showed a positive correlation with the frequency of daily, weekly, or monthly glucose checking.

This study underscores the significance of SMBG in children and adolescents with T1DM. The findings emphasize the critical role of price and availability of glucometers and strips in achieving standard care for T1DM patients.

In infectious diseases, there are essential indices used to describe the disease state. In this study, we estimated the basic reproduction number, R0, peak level, doubling time, and daily growth rate of COVID-19.

This ecological study was conducted in 5 provinces of Iran. The daily numbers of new COVID-19 cases from January 17 to February 8, 2020 were used to determine the basic reproduction number (R0), peak date, doubling time, and daily growth rates in all five provinces. A sensitivity analysis was conducted to estimate epidemiological parameters.

The highest and lowest number of deaths were observed in Hamedan (657 deaths) and Chaharmahal and Bakhtiari (54 deaths) provinces, respectively. The doubling time of confirmed cases in Kermanshah andHamedan ranged widely from 18.59 days (95% confidence interval (CI): 17.38, 20) to 76.66 days (95% CI: 56.36, 119.78). In addition, the highest daily growth rates of confirmed cases were observed in Kermanshah (0.037, 95% CI: 0.034, 0.039) and Sistan and Baluchestan (0.032, 95% CI: 0.030, 0.034) provinces.

In light of our findings, it is imperative to tailor containment strategies to the unique epidemiological profiles of each region in order to effectivelymitigate the spread and impact of COVID-19. The wide variation in doubling times underscores the importance of flexibility in public health responses. By adapting measures to local conditions, we can better address the evolving dynamics of the pandemic and safeguard the well-being of communities.

Underestimation is a common problem in cancer registries in developing countries. This study introduces a Bayesian approach as a method for correcting undercounts in cancer data, before population-based cancer registry program

The current study is a secondary study performed on data from the cancer registry system. Our analysis focused on utilizing data before the establishment of the population-based cancer registry program in Iran. We employed the Bayesian approach to correct undercounting from 2005 to 2010. The ratio of pathology to population-based in the cancer registry data of Golestan province for four age groups and each year was used as the initial value in the Bayesian method.

The results of this study showed that the lowest percentage of undercounting belonged to Khorasan Razavi province with an average of 21% and the highest percentage belonged to Sistan and Baluchestan province with an average of 38%.
The average age-standardized incidence rate (ASR) for all provinces of the country except Golestan province was equal to 105.72 per 100,000 and after Bayesian correction was 137.17 per 100,000. In 2010 the amount of ASR before Bayesian correction was 100.28 per 100,000 for women and 136.49 per 100,000 for men. Also, after implementing the Bayesian correction, ASR increased to 125.74 per 100,000 for women and 172.79 per 100,000 for men.

The study demonstrates the effectiveness of the Bayesian approach in correcting undercounting in cancer registries. By utilizing the Bayesian method, the average ASR after Bayesian correction with a 29.74 percent change was 137.17 per 100,000. These corrected estimates provide more accurate information on cancer burden and can contribute to improved public health programs and policy evaluation. The findings of this research highlight the appropriateness of using the Bayesian method to correct underestimation in cancer registries and underscore its significance for future studies.

 Although the effect of drug addiction on suicide attempts has been extensively studied, not enough attention has been paid to the role of family members’ drug addiction in women’s suicide attempts.

 The present study aimed to examine the impact of drug addiction in the family on women’s suicide attempts.

 This case-control study was conducted on 220 women, aged 15 - 65 years, with a history of suicide attempts, as well as 220 control women without a history of suicide attempts in Golestan, Iran, during 2020. Demographic characteristics, as well as data pertaining to drug abuse and mental health variables, were collected. Firth’s penalized logistic regression method was used for multivariate analysis and modeling, and the area under the curve (AUC) and net reclassification improvement (NRI) were measured to determine the added diagnostic value.

 The AUC increased by 4.6% by adding the variable of “addiction in the family” to the model, which consisted of variables, including the blood group, education level, living area, tobacco smoking, and experience of suicidal thoughts. Besides, the NRI was equal to 0.61.

 Drug addiction in the family is an effective factor for suicide attempts in women. Consequently, women whose parents or partners are drug addicts are at a higher risk of suicide attempts.

Pregnant women infected with the coronavirus disease 2019 (COVID-19) are at risk for adverse pregnancy outcomes, and the only real preventive strategy against COVID-19 is mass vaccination. This study aimed to examine the effectiveness, immunogenicity, and safety of Covid-19 vaccination in pregnant women.  

  A combination of search terms was performed by 2 researchers independently in the Web of Science, PubMed, and Scopus databases, the World Health Organization website, and the US Centers for Disease Control (CDC) website up to February 2022. After the selection of eligible studies, the review process, description, and summarization of the selected studies were performed by the research team.  

Finally, 22 articles were included in this study. Evidence supports the safety of COVID-19 vaccination during pregnancy. There is no risk of transmitting COVID-19 to infants during lactation. In addition, antibodies made by vaccination can protect infants through breast milk.  

The scientific community believes that being vaccinated as soon as possible is the best course of action because there is no evidence to suggest that the COVID-19 vaccine poses a risk to expectant or nursing women.

In 2020, shortly after recognizing the COVID-19 virus in China on March 11, the World Health Organization (WHO) declared the Covid-19 outbreak a pandemic. It is estimated that COVID-19 is responsible for millions of morbidities and deaths globally, causing devastating health, social and economic crises. This ecologic study aimed to define the correlation between a few key elements of a national health system (i.e., quality of health care services, rate of provided COVID-19 diagnostic tests, and coverage of flu vaccine in the preceding years of the COVID-19 pandemic) and the fatality rate of COVID-19 in countries that were affected by the Covid-19 epidemic in the early phase of the pandemic. In this ecological study, data regarding the total population, number of active cases, total cases, mortality, and time to peak of the COVID-19 epidemic for the countries with defined criteria and the required data available were collected from the Worldmeter database. Thehealth system quality of the selected countries was obtained using a report by WHO (Measuring Overall Health System Performance for 191 Countries). The Flu vaccine coverage of the selected populations was ordered and ranked using graphs provided by a joint VENICE–ECDC–WHO survey. The analysis was done by fitting meta-regression using rates and confidence intervals. A forest graph was used to show the summary of the results. R version 6.3 (package meta) was used to do the analysis. The average Case fatality rate (CFR) of the 26 selected countries was 115 per 1000 for COVID-19. Testing for heterogeneity suggested that CFR was highly heterogeneous among the countries. The regression analysis results suggested that CFR for COVID-19 was inversely related to the rate of COVID-19 diagnostic tests and was directly related to the rate of flu vaccine coverage). The direct correlation between flu vaccine coverage and CFR of COVID-19 may suggest a positive effect of the natural circulation of flu infection on the effectiveness of the individuals’ immune response. Also, the natural flu infection may protect those who could not tolerate the respiratory complications of COVID-19 infection. The results may help NHSs to cope better with future pandemics. In addition, to provide a faster and more effective response to any future infectious pandemic, better access to diagnosis tests seems to be an effective approach in reducing morbidity and mortality.

Volumetric measurement through water displacement and circumferential measurement is commonly employed for lymphedema diagnosis. This study aimed to investigate the association between diagnostic thresholds of circumferential and volumetric arm measurements in patients with breast cancer.

This was a cross-sectional study on patients with breast cancer related lymphedema presenting to a lymphedema clinic in Tehran between 2009 and 2019. Demographic characteristics, circumferential measurements (at seven time points along the upper limb), and volumetric measurements (using the water displacement method) were extracted from patient documents. Inter-limb circumference differences of >2 cm and ≥2 cm, >5 cm and ≥5 cm for the sum of all circumference measures, inter-limb volume differences of >10% and ≥10%, >200 and ≥200 ml were assessed. We examined the association between different indices by Cohen’s kappa coefficient and evaluated the accuracy of circumference measurements compared to volumetric measurements.

Totally 4647 cases were assessed for circumference and volumetric measurements. Substantial agreement was found between circumference index >2 and >5 cm (Kappa=0.720), and circumference index >2 and volumetric index >10% (Kappa =0.628). The >2cm index had a higher association with >200 ml (R2= 0.296). Considering the volume difference of >200 ml as a standard index, the ≥2 cm index had the highest sensitivity (90.74%) and accuracy (83.19%) compared to other indices.

Considering the index >200 ml as the standard volumetric threshold, the highest sensitivity and accuracy were related to the index ≥2 cm. About 30% of edema volume changes could be predicted by circumferential measurement. It seems that evaluating the effect of other variables influencing edema estimation should be assessed in future studies.

 Suicide risk factors can be used to develop tools for suicide attempt prediction and prevention.

 We aimed to design a model to evaluate the risk of suicide related to socio-economic, demographic, health, and drug dependency factors.

 This case-control study was conducted in a 15-65-year-old population of Golestan province, Iran. The case group included 414 individuals with a history of suicide in 2019, and the control group had 408 individuals without suicide attempts. Demographic, psychosocial health, and drug dependency data were collected. Modeling was carried out using multivariate logistic regression. The performance of suicide-predicting models was assessed, and a nomogram for the probability of suicide was drawn.

 A multivariate logistic regression model with age, gender, education level, mother's education level, marital status, life satisfaction, membership in cyberspace, sleep disorders, alcohol abuse, having suicidal thoughts, the interaction of gender with life satisfaction, and the interaction of gender with mother's education level was the best predicting model of suicide attempt (AUC = 0.934, CI: 0.91 - 0.95). The variables of father's education level, occupation, job satisfaction, household size, financial status, regular exercise, guardianship status, history of self-harm, history of suicide attempt in the family, smoking and drug abuse had no significant relationship with suicide attempt.
5.1.

 The results suggest that designed models can help mental health service providers to identify high-risk individuals early. So we can better manage suicide and reduce its economic, social, and health burdens.

Community-based interventions can be effective due to the active participations of communities in pre- and post-disaster planning and management. Effective community-based disaster management for health promotion can be achieved by learning from the successful local and international experiences of community participations. Thus, this study is aimed to identify the community active participation approaches which were effective in promoting the health of disaster-affected communities.

This systematic review was conducted and reported based on PRISMA guideline. Web of Sciences, PubMed and Scopus were searched using the selected keywords. The inclusion criteria were all forms of published articles which studied the approaches of community active participations for improving their health in disasters. The selection of articles was conducted using the titles and abstracts. Data analysis was done based on the categorization of different community-based disaster management approaches. 

10 articles were finally selected out of 2843 documents generated by initial search. Asian countries considered community involvements in disaster management the most (40%). The most community active participations in disaster management were conducted in the recovery phase (80%). Approaches of community-based disaster management for the health promotion were two-way university-community participation, focusing on empowering specific community groups, governance, and localizing community participation as well as strengthening social networks.

Considering the capacities of academic institutions for active participation in community-based disaster management according to the Yokohama, Hyogo and Sendai Framework is highly suggested. Further research is needed to explore the challenges of community communication and information in disasters.

Myocardial infarction (MI), is considered as an important cause of death and disability. About three - quarters of the deaths caused by heart diseases occur in countries with low or middle economic levels. Evaluation of the effective risk factors and medications and the overlap of their compounds on the long - term survival of patients with myocardial infarction

In this retrospective cohort study 21181 patients, hospitalized in coronary care units (CCU) hospitals of Iran enrolled from the MI registry system for the period of 20 March 2013 to 20 March 2014.
Participants were followed up to February 2020 for any cardiovascular disease (CVD) mortality. To evaluate survival rate, difference between groups and to assess factors related to MI death, Kaplan–Meier, Log rank test and Cox Proportional-Hazards Model were used, respectively.

The mean age of patients was 62.10± 13.41. 72.37 % of the patients were men. The rate of survival in the time period in females was less than males. For those patients without the history of coronary diseases, hypertension, and diabetes but with hyperlipidemia and smoking, the 1, 3, 5, and 7-year survival rates were better compared to other patients. The 1, 3, 5, and 7-year survival rates of those in group 6 (Beta blocking agent) were higher compared to other medication groups.

Controlling risk factors can reduce the mortality rate, and the recommendations of doctors and adherence treatment plays an important role in the long - term survival of Myocardial infarction patients.

COVID-19 is an international public health emergency in the world.

The aim of the present study is to determine the geographic pattern and temporal trend of Coronavirus disease 2019 incidence, fatality, and recovery rates worldwide.

The present ecological study is a mixed exploratory study. The study population included Patients with COVID-19, recovered individuals, and deaths from COVID-19 from October 1, 2019, until June 30, 2021, worldwide. Descriptive analysis included the calculation cumulative incidence rate (CIR), case fatality rate (CFR), and case recovery rate (CRR) of COVID-19. Global Moran's I and Anselin Local Moran's I tests were used for spatial analysis. The joinpoint regression analysis was used to examine the time trend by ArcGIS, Joinpoint, and SPSS software.

The average cumulative incidence rate was 1077 in 106 individuals; also, the average case recovery rate and average case fatality rate were %72.81 and %3.21, respectively. Global Moran's I index measured for CIR was 0.159. The results of Anselin's local Moran's I, high-high cluster, consists of some countries in South America and in southern and Western Europe and central and western Asia. The temporal trend of changes in the incidence rate and CRR of COVID-19 were incremental, and the average annual percentage change from October 2019 to June 2021 increased by 44.4% and 3.2%, respectively (P < 0.001), but CFR decreased by -0.3% and was not significant (P > 0.05).

As regards the specific spatial pattern of fatality and recovery rate of COVID-19, it seems essential to consider spatial conditions and environmental factors which are related to the incidence and fatality of COVID-19 in different regions, as well as the necessity of upgrading the care system in high-risk areas, in order to have better management and control of the pandemic and optimal function in early diagnosis, proper treatment, and high vaccination coverage.

To end the new COVID-19 pandemic, most of the world’s population needs to be immune to the virus, protecting individuals from infection, and ultimately ensuring herd immunity at the population level. A variety of COVID-19 vaccines have been developed worldwide for adults and children over the age of 12 years, and the effectiveness of the vaccine in preventing symptomatic diseases and hospitalization is being studied. One of the major obstacles to COVID-19 vaccination that has emerged along with the global immunization program is vaccine hesitation or disapproval. The World Health Organization (WHO) has reported vaccine hesitation as one of the 10 global health threats of 2019. This is also related to COVID-19.The present review, explore the current evidence on COVID-19 vaccination platforms and vaccination efficacy, safety, and adverse effects among strategic sub-populations, including elderly people, people with chronic disease (diabetes, cancer), pregnant and lactating women, children, youth, and vaccination willingness or hesitancy among the target population.

The aim of this qualitative study was to explain the reasons for using smokeless tobacco based on the grounded theory approach.

We conducted a qualitative study using the grounded theory approach in 2020 - 2021. Participants were adult users of smokeless tobacco in Chabahar city, southeast Iran. The strategy for choosing participants was based on purposeful sampling and continued till theoretical saturation was achieved. Thirty adults who were smokeless tobacco users participated in the interviews voluntarily. We used techniques such as asking questions, constant comparisons, and writing memos to collect data, which were analyzed based on the grounded theory presented by Corbin and Strauss in 2008.

Two themes emerged from data analysis (the context of consumption and the need for effective supervision), each of which had several subcategories. The opportunity for consumption was the first main category of the contextual factors frequently mentioned by the participants, whose subcategories included consumption culture, individual and general beliefs, and consumption by family members. Insufficient supervision was the second main category, which included three subcategories, profitable market, insufficient supervision, and easy access.

In general, two main themes explain the tendency of adults to consume smokeless tobacco: The context of consumption and the need for effective supervision. Concepts such as the consumer’s culture, individual and public beliefs, family members and friends being users, profitable market, the need for effective supervision, and easy access were the key factors pushing people of different ages toward using smokeless tobacco in Chabahar city.

 The World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) outbreak to be a public health emergency and international concern and recognized it as a pandemic. This study aimed to estimate the epidemiologic parameters of the COVID-19 pandemic for clinical and epidemiological help.

 In this systematic review and meta-analysis study, 4 electronic databases, including Web of Science, PubMed, Scopus, and Google Scholar were searched for the literature published from early December 2019 up to 23 March 2020. After screening, we selected 76 articles based on epidemiological parameters, including basic reproduction number, serial interval, incubation period, doubling time, growth rate, case-fatality rate, and the onset of symptom to hospitalization as eligibility criteria. For the estimation of overall pooled epidemiologic parameters, fixed and random effect models with 95% CI were used based on the value of between-study heterogeneity (I2).

 A total of 76 observational studies were included in the analysis. The pooled estimate for R0 was 2.99 (95% CI, 2.71-3.27) for COVID-19. The overall R0 was 3.23, 1.19, 3.6, and 2.35 for China, Singapore, Iran, and Japan, respectively. The overall serial interval, doubling time, and incubation period were 4.45 (95% CI, 4.03-4.87), 4.14 (95% CI, 2.67-5.62), and 4.24 (95% CI, 3.03-5.44) days for COVID-19. In addition, the overall estimation for the growth rate and the case fatality rate for COVID-19 was  0.38% and 3.29%, respectively.

 The epidemiological characteristics of COVID-19 as an emerging disease may be revealed by computing the pooled estimate of the epidemiological parameters, opening the door for health policymakers to consider additional control measures.

In the classification of road accidents, type 2 traffic accidents and non-traffic accidents are not considered and in Iran so far no special study has been done in the field of type 2 traffic accidents and non-traffic accidents, so we aimed to investigate the incidence of type 2 traffic accidents and non-traffic accidents in Iran.

This cross-sectional was conducted on all individuals referred to Forensic Medicine Organization (FMO) from all over Iran who suffered from non-traffic accidents and type 2 traffic accidents during 2013-2018. Demographic information, accident information and other information including the location of the impact, the final cause of death and the date of the accident were examined. The information received from the FMO was first checked and then analyzed using Stata 11 statistical software.

During the 6-year study period, 10882 people lost their lives in type 2 traffic accidents (4779 people) and non-traffic accidents (5287 people). In terms of age, the highest incidence of type 2 traffic accidents and non-traffic accidents was observed in the age group over 65 years. The incidence of type 2 traffic accidents has not been increasing, while the trend of non-traffic accidents has been increasing.

With respect to the high rate of deaths due to traffic accidents, including type 2 traffic accidents and non-traffic accidents, it is necessary for the national media and relevant agencies to educate the people about first aid and also inform about free relief services, timely presence is important.

Coronary artery disease is among the first causes of death in Iran. Secondary prevention with drug therapy is recommended following acute myocardial infarction (MI) to reduce the risk of new cardiovascular events and death.

This is a retrospective cohort study on data collected from 21181 cases of MI recorded by the MI Registry of Iran from 2013 to 2014. Ten therapies that were prescribed to patients at the time of discharge were divided into 6 groups. Survival rates were estimated using the Kaplan-Meier method and Cox regression analysis.

The most common MI location was in the anterior wall (31.87%). Anticoagulants, aspirin, clopidogrel were the most common prescribed medications (94.73%). Overall, 28-day (short-term) and 3-year survival rates were 0.95 (95% CI: 0.95–0.96) and 0.82 (95% CI: 0.81–0.82). In non-ST-elevation myocardial infarction (NSTEMI) patients, the lowest short- and long-term survival rates were observed when diuretic, anticoagulants/ aspirin and clopidogrel, beta-blockers and statins medication were simultaneously taken and the highest short- and long-term survival rates were observed in patients who took anticoagulants, aspirin and clopidogrel, nitrate agent and calcium blockers, beta-blockers and statins medication. In STEMI patients, the lowest short- and long-term survival rates were observed when diuretic, anticoagulants, aspirin and clopidogrel, nitrate agent and calcium blockers, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) were simultaneously taken. The highest short- and long-term survival rates were observed in patients who received anticoagulants, aspirin and clopidogrel, nitrate agent and calcium blockers, beta-blockers, statins, ACEIs and ARBs.

Prescription of the best combination of drugs, in addition to adherence to a healthy lifestyle and medication, can improve the survival rates after MI.

Iran is one of the first few countries that was hit hard with the coronavirus disease 2019 (COVID-19) pandemic. We aimed to estimate the total number of COVID-19 related infections, deaths, and hospitalizations in Iran under different physical distancing and isolation scenarios.

We developed a susceptible-exposed-infected/infectious-recovered/removed (SEIR) model, parameterized to the COVID-19 pandemic in Iran. We used the model to quantify the magnitude of the outbreak in Iran and assess the effectiveness of isolation and physical distancing under five different scenarios (A: 0% isolation, through E: 40% isolation of all infected cases). We used Monte-Carlo simulation to calculate the 95% uncertainty intervals (UIs).

Under scenario A, we estimated 5 196 000 (UI 1 753 000-10 220 000) infections to happen till mid-June with 966 000 (UI 467 800-1 702 000) hospitalizations and 111 000 (UI 53 400-200 000) deaths. Successful implantation of scenario E would reduce the number of infections by 90% (ie, 550 000) and change the epidemic peak from 66 000 on June 9, to 9400 on March 1, 2020. Scenario E also reduces the hospitalizations by 92% (ie, 74 500), and deaths by 93% (ie, 7800).

With no approved vaccination or therapy available, we found physical distancing and isolation that include public awareness and case-finding and isolation of 40% of infected people could reduce the burden of COVID-19 in Iran by 90% by mid-June.

Clinical manifestations of COVID–19 are different. There are some risk factors for COVID–19. This study aimed to describe the epidemiological features, symptoms and mortality of the patients with COVID–19 in Iran.

This were a cohort study performed on 103,179 patients with COVID–19. The demographic and clinical data were collected in selected provinces. The required data of all patients was extracted from the COVID registry system and analyzed using STATA version 14 and Excel 2016.

The mean age was 52.40 years for men and 52.41 years for women. About 55.2% of the study population were male and 44.8% were female. Totally, 60.9% (5085) of deaths happened in men and 39.1% (3263) in women. The mean time from onset of symptoms to hospitalization in men and women were 3.47 and 3.48 days, respectively. The mean time from onset of symptoms to isolation was 2.81 days in men and was 2.87 days in women, from onset of symptoms to death was 9.29 and 9.54 days, respectively, from onset of symptoms to discharge was 7.47 and 7.39 days, and from hospitalization to death was 6.76 and 7.05 days. Cough and shortness of breath were the most common symptoms in the patients.

According to the results, the overall mortality rate was higher in men than women. Women with cardiovascular disease and diabetes were more likely to die. The mean time from onset of symptoms to hospitalization, isolation, and discharge was similar in men and women.

Coronary artery disease is the most common cause of death worldwide as well as in Iran. The present study was designed to predict short and long-term survival rates after the first episode of myocardial infarction (MI).

The current research is a retrospective cohort study. The data were collected from the Myocardial Infarction Registry of Iran in a 12-month period leading to March 20, 2014. The variables analyzed included smoking status, past medical history of chronic heart disease, hypertension, diabetes, hyperlipidemia, signs and symptoms during an attack, post-MI complications during hospitalization, the occurrence of arrhythmias, the location of MI, and the place of residence. Survival rates and predictive factors were estimated by the Kaplan–Meier method, the log-rank test, and the Cox model.

Totally, 21 181 patients with the first MI were studied. There were 15 328 men (72.4%), and the mean age of the study population was 62.10±13.42 years. During a 1-year period following MI, 2479 patients (11.7%) died. Overall, the survival rates at 28 days, 6 months, and 1 year were estimated to be 0.95 (95% CI: 0.95 to 0.96), 0.90 (95% CI: 0.90 to 0.91), and 0.88 (95% CI: 0.88 to 0.89). After the confounding factors were controlled, history of chronic heart disease (p<0.001), hypertension (p<0.001), and diabetes (p<0.001) had a significant relationship with an increased risk of death and history of hyperlipidemia (p<0.001) and inferior wall MI (p<0.001) had a significant relationship with a decreased risk of death.

The results of this study provide evidence for health policy-makers and physicians on the link between MI and its predictive factors.

The unknowingness of COVID-19 compared to other respiratory diseases and gaining an overview of its diagnostic criteria led to this study, which was designed to summarize the signs and symptoms along with the clinical tests that described these patients.

PubMedMEDLINE, Web of Science, Core Collection, Scopus, and Google Scholar were systematically searched on September 27, 2020. After screening, we selected 56 articles based on clinical characteristics and laboratory and imaging findings in confirmed COVID-19 patients as eligibility criteria. To evaluate risk of bias, the Newcastle Ottawa scale, for publication bias, Egger’s test, and for heterogeneity, I2 and tau test were used; and finally, random-effects models were used for pooled estimation.

Pooled estimates for frequently clinical symptoms were as follows: fever (78% [95% CI, 74-82]), cough (60% [95% CI, 57-63]), and fatigue (31% [95% CI, 26-36]); and they were as follows for laboratory findings in lymphocyte (1.02 [95% CI, 0.92-1.12]), CRP (19.64 [95% CI, 13.96- 25.32]), and platelet count (175.2 [95% CI, 165.2-185.2]); they were as follows for imaging findings in bilateral pneumonia (64% [95% CI, 56-72]), and ground glass opacity (60% [95% CI,  48-7]). Also, in the subgroup analysis, bilateral pneumonia with 18% and fatigue with 15%, had the highest difference in values between the groups.

According to Forest plots, the CI and dispersion among studies were smaller in laboratory findings than in symptom and imaging findings, which might indicate a high alignment in the laboratory findings among studies.

The basic reproduction number (R0) is an important concept in infectious disease epidemiology and the most important parameter to determine the transmissibility of a pathogen. This study aimed to estimate the nine-month trend of time-varying R of COVID-19 epidemic using the serial interval (SI) and Markov Chain Monte Carlo in Lorestan, west of Iran. Study design: Descriptive study.

This study was conducted based on a cross-sectional method. The SI distribution was extracted from data and log-normal, Weibull, and Gamma models were fitted. The estimation of time-varying R0, a likelihood-based model was applied, which uses pairs of cases to estimate relative likelihood.

In this study, Rt was estimated for SI 7-day and 14-day time-lapses from 27 February-14 November 2020. To check the robustness of the R0 estimations, sensitivity analysis was performed using different SI distributions to estimate the reproduction number in 7-day and 14-day time-lapses. The R0 ranged from 0.56 to 4.97 and 0.76 to 2.47 for 7-day and 14-day time-lapses. The doubling time was estimated to be 75.51 days (95% CI: 70.41, 81.41).

Low R0 of COVID-19 in some periods in Lorestan, west of Iran, could be an indication of preventive interventions, namely quarantine and isolation. To control the spread of the disease, the reproduction number should be reduced by decreasing the transmission and contact rates and shortening the infectious period.

Given the increasing prevalence of methadone overdose and the growing number of deaths in Iran, the present study was conducted to determine the mortality rate of methadone detected in the cadavers brought to the Forensic Medicine Organization between 2015 and 2017.

This cross-sectional study was performed on 7,486 cases of substance abuse deaths registered in the Forensic Medicine Organization during 2015-2017. In order to investigate the drug abuse, samples collected from the cadavers were initially examined for their drug contents, such as methadone, by standard screening methods and then confirmed by thin layer chromatography (TLC). Using two checklists, the information collected about each cadaver consisted of the identity, autopsy and laboratory data. After data collection, they were entered into the Stata software version 14 MP.

The cadavers’ mean age was 36.6±12.6 years. Over the 3-year duration of the study, the standardized mortality rate increased from 35 to 39 cases per million per year. Of these cases, 6066 were randomly assigned to toxicology, 50.1% had used methadone one month before their death. Approximately 75% of the methadone abusers had taken another drug simultaneously, mostly morphine or methamphetamine.

Considering the relatively high prevalence of methadone detected post-mortem, monitoring for methadone entry into public market and identifying the death-related factors in the drug abusers are considered as significant measures to improve upon the current alarming situation in the Iranian society.

Road traffic accidents (RTAs) have become an important public health problem and the mortality rate due to RTAs in Iran is significantly higher than the international standards. There is no accurate information about the mortality rate caused by heavy vehicles in Iran. Therefore, this study aimed at evaluating road traffic mortality caused by heavy vehicles in Iran.

In this cross‑sectional study, the mortality rate caused by heavy vehicles was evaluated regarding age, sex, marital status, education, place and type of accident, and traffic classification. The relative frequency percentage was used for descriptive analysis. T‑test, Chi‑square, and one‑way ANOVA were used to examine the relationship between the variables.

Atotal of 3560 persons died only due to heavy vehicle accidents, and the age‑standardized mortality rate was 4.34 per 100,000 populations. The mean age of the victims was 38.9 ± 20.8 years. Furthermore, 80% of the victims were male. Results showed that 83% of all deaths occurred outside cities, and the most common type of vehicle used by the victims was truck and trailer. The highest percentage (57.3%) of accidents was related to heavy and light vehicles.

The rate of RTAs‑related mortality rate caused by heavy vehicles in Iran is higher than the basic international rate, and there is a need to investigate the causes of this issue.