فهرست مطالب saeid fallah

Reinfection and hospital readmission due to COVID-19 were significant and costly during the pandemic. This study aimed to assess the rate and risk factors of SARS-Cov-2 reinfection, recurrence, and hospital readmission, by analyzing the national data registry in Iran.

This study was a retrospective cohort conducted from March 2020 to May 2021. A census method was used to consider all of the possible information in the national Medical Care Monitoring Center (MCMC) database obtained from the Ministry of Health and Medical Education; the data included information from all confirmed COVID-19 patients who were hospitalized and diagnosed using at least one positive Polymerase Chain Reaction (PCR) test by nasopharyngeal swab specimens. Univariate and multivariable Cox regression analyses were performed to assess the factors related to each studied outcome.

After analyzing data from 1,445,441 patients who had been hospitalized due to COVID-19 in Iran, the rates of overall reinfection, reinfection occurring at least 90 days after the initial infection, recurrence, and hospital readmission among hospitalized patients were 67.79, 26.8, 41.61, and 30.53 per 1000 person-years, respectively. Among all cases of hospitalized reinfection (48292 cases), 38.61% occurred more than 90 days from the initial SARS-Cov-2 infection. Getting infected with COVID-19 in the fifth wave of the disease compared to getting infected in the first wave (P<0.001), having cancer (P<0.001), chronic kidney disease (P<0.001), and age over 80 years (P<0.001) were respectively the most important risk factors for overall reinfection. In contrast, age 19-44 years (P<0.001), intubation (P<0.001), fever (P<0.001), and cough (P<0.001) in the initial admission were the most important protective factors of overall reinfection, respectively.

Reinfection and recurrence of COVID-19 after recovery and the rate of hospital readmission after discharge were remarkable. Advanced or young age, as well as having underlying conditions like cancer and chronic kidney disease, increase the risk of infection and readmission. 

 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.

 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.
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 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.

Atrichia with papular lesions (APL) is a rare autosomal recessive disease caused by a genetic mutation in the human hairless gene’s zinc finger domain. It suddenly appears in the first months after birth and causes irreversible hair loss and keratin cysts on the head, face, and other body parts. Our patient is a 31-year-old female of a consanguineous marriage living in a deprived and remote city of Iran. She suffered from total hair loss and papules spreading all over the body. The patient showed no signs of other physical or mental health issues; she also had healthy physical growth and standard eyesight and hearing. Bone and teeth development were developed, and sweat glands were also robust. APL was diagnosed based on the clinical findings (total hair loss, emergence of papules, morbidity over the body from early childhood, and hypopigmented suture-like lines on the scalp), standard laboratory tests rejecting other differential diagnoses, and lack of response to all available treatments.

Brucellosis is one of the most prevalent bacterial zoonotic diseases considered as a public health problem in Golestan province (north-east of Iran), but its spatial pattern remains unclear. Hence we evaluated the spatial analysis of brucellosis disease in Golestan province during 2015-2017. In this study, we explored the Spatial and Spatiotemporal clusters by using scan-statistic to consider influencing factors. In addition, logistic regression and Pearson’s chi-square tests were used to analyze the clusters' zones and compare them with others. We used GIS to determine unites' (Golestan cities) coordinate centers and visualize the location of the clusters. Results revealed that the geographical distribution of brucellosis in Golestan province was affected by several spatial and spatiotemporal clusters. Constituent units of both spatial and spatiotemporal clusters were the same, but the identified time period of spatiotemporal clusters was from January 2015 to June 2016. The main influencing factors were in contact with livestock and dairy hygiene. This study can assist health authorities to plan more effectively to control diseases by highlighting the high-risk areas and behaviors.

Mosquitoes (Diptera: Culicidae) is one of the most medically important families of Diptera. The aims of this study were to determine fauna and larval habitat characteristics of mosquitoes in Golestan Province, during 2014–15. This study was conducted in larval habitats of mosquitoes and installed ovitraps in 14 districts of Golestan Province, Northern Iran in 2015. Samples were collected with a scoop by ladle handling for entomology. The col lected larvae were transferred to Laboratory of Medical Entomology in lactophenol solution. Then microscopic slides were prepared using de Faure's formula. Species of each sample was recognized using diagnostic criteria to identify the Culicidae species. Characteristics of larval breeding places were studied based on the habitat type (Permanent or temporary), water conditions (Clear or turbid, stagnant or running), vegetation (out, in, underwater vegetation or without vegetation), sunlight exposure (Full or partial sunlight) and so on. Data were analyzed using SPSS. Overall, 5661 third- and fourth- instars larvae of mosquitoes were collected and 5 genera and 14 species were identified: Anopheles hyrcanus, An. maculipennis, An. pseudopictus, An. superpictus, Culex hortensis, Cx. mimiticus, Cx. perexiguus, Cx. pipiens, Cx. pusillus, Cx. theileri, Cx. tritaeniohynchus, Culiseta longiareolata, Och lerotatus caspius, Uranotaenia unguiculata. Culex pipiens was recognized as predominant species of the family. Among the detected species, Cx. pusillus reported for the first time from Golestan Province. Due to the high species diversity of Culicidae, ecology of medical important species such as Cx. pipiens and Cx. tritaeniorhynchus needs more investigations.

The tetrad of bronchial asthma, severe sinusitis, nasal polyp, eosinophilia, and systemic vasculitis is the main feature of allergic granulomatosis and angitis (Churg- Strauss Syndrome). This vasculitis is usually seen idiopathic in patients with a long history of asthma; oral steroids using steroid inhalers, vaccination and desensitization might be triggering factors. Drugs such as leukotriene receptor antagonists (LTRAS), penicillin, sulphonamides, anticonvulsants and thiazides have also been implicated. By presenting the cases in this article, the authors suggest that some cases of CSS may be partially or totally suppressed by corticosteroid therapy of asthma for long periods and replacing oral steroid by inhaler will reveal a pathologic condition of CSS, called frustes CSS forms. We report three subjects with asthma who had been receiving previously multiple corticosteroid courses for control, but when systemic corticosteroids were discontinued or switched over to steroid inhaler, the patients developed a similar syndrome.