symptoms

The present investigation examines the impact of aerobic exercises, especially swimming and running wheel exercises, on the clinical manifestations and myelin basic protein (MBP) levels in mice with experimental autoimmune encephalomyelitis (EAE), an animal model for multiple sclerosis (MS). MBP is critical for the formation of myelin sheaths within the nervous system, and its deterioration is linked to the pathogenesis of MS.

The sample of the study consisted of 96 female C57BL/6 mice. After the EAE induction, the mice were divided into 8 groups. The animals performed two exercise protocols. Then, the brain tissue was isolated, and levels of the mentioned variables were measured via the ELISA method using specific kits. The data were analyzed statistically using one-way ANOVA.

Results showed that lesion scores in both exercise protocols were lower in EAE mice than those in the control groups (P=0.001); in other words, swimming and receiving interferon-beta-1 reduced MBP degradation, but the decrease was not significant (P=0.09). Additionally, running wheels reduced MBP degradation, which was statistically significant (P=0.001).

Results suggested that using a voluntary running wheel might be a more effective exercise program than swimming in preventing MBP degradation in the brain tissues of mice with EAE.

COVID‑19 causes many respiratory problems. The most common clinical manifestation is acute respiratory failure. Respiratory rehabilitation is an important part of treatment, but little is known about it. This study was carried out to determine the effect of deep respiration and prone position on common respiratory symptoms in patients with COVID‑19.

In this clinical trial that was conducted in a hospital in Yasuj city, Iran, in 2021, 96 patients with COVID‑19 were selected using a non‑random convenience sampling method and were randomly assigned to three groups of deep respiration, prone position, and deep respiration and prone position. Data were collected using the Borg Rating of Perceived Exertion scale, the Visual Analog Scale, pulse oximetry, and a researcher‑made checklist of patients’ respiratory rates. The interventions were performed for 1 week (2–8 hours daily) based on patient tolerance. Data were collected before and immediately after the intervention.

There was no statistically significant difference (p > 0.05) among the three groups in terms of mean score of shortness of breath, intensity of symptoms, oxygen saturation of blood, and respiration rate before the interventions; however, significant differences were observed after the interventions (p < 0.05) in the three groups.

Deep respiration with prone position could improve respiratory symptoms in patients with COVID‑19 more than deep respiration or prone position alone. Respiratory exercise should be considered as a part of nursing cares and patients with respiratory symptoms should receive education in this regard.

COVID-19 is an infectious disease that has spread all over the world and has endangered health care system. Several studies have shown an association between Plant-based diets and the health benefits. This study aimed to investigate the association between Plant-based Diet Index (PDI) and severity and symptoms of COVID-19.

In a cross-sectional study, 684 patients recovered from COVID-19 were included. Dietary intakes of subjects were assessed using a validated 168-item food frequency questionnaire and PDI, healthful PDI (hPDI) and unhealthful PDI (uPDI). The outcomes such as severity of disease, symptoms and levels of inflammatory biomarkers were assessed through telephone interviews with the participants.

After adjusting for several confounders, participants at the highest quartile of PDI showed lower risks for hypoxia, duration of disease and hospitalization and a lower level of ESR. PDI score was negatively associated with risk of COVID-19 symptoms including fever, chill, weakness, myalgia, chest pain, headache, dizziness, sore throat, diarrhea, nausea, vomiting and anorexia. A greater hPDI score was associated with reduced risk of sever COVID-19, hypoxia, need to respiratory support, lower duration of disease, recovery, lower level of CRP and ESR. A higher uPDI score was associated with greater risk of severe COVID-19, need to respiratory support, duration of disease, higher level of CRP and ESR.

We found that higher PDI was associated with lower risk of COVID-19 outcomes. Also, higher hPDI and lower uPDI scores were associated with reduced risk of sever COVID-19.

One of the biggest factors reportedly interfering with the lives of individuals who suffer from multiple sclerosis (MS) is fatigue. Prior research has demonstrated that combined training may benefit patients with MS. However, it has not been studied how combined exercise can lessen fatigue in people with MS. This systematic review and meta-analysis summarizes the results of studies that examine the effects of combined training on fatigue in individuals with MS.

We investigated randomized controlled studies (RCTs) that examined how combination training affected fatigue and were published from the start of the research until May 2024. The Wiley online library, PubMed, Medline, PEDro, ScienceDirect, and Frontiers were among the electronic databases that were searched. PEDro and McMaster’s measures were used to assess the quality of included research. 

The study’s requirements were satisfied by six RCTs with 279 participants. Using a random effect model of meta-analysis, the weighted mean differences of fatigue were 1.81 (95% CI, 2.83%, 0.79%) with P=0.002. Accordingly, exercise training is useful in lowering fatigue in individuals with MS since all included RCTs revealed significant differences between the subjects assigned to the combined exercise group and the control group. 

Combined training can be a useful strategy for helping individuals with MS manage their weariness.

The global population has been under threat of ongoing COVID-19 pandemics. Diet was shown to significantly impact the severity of the disease. The primary focus of this research is to explore the potential correlation between consuming nuts and the severity of COVID-19 symptoms.

Totally, 684 individuals who recovered from COVID-19 were enrolled; while 168-item frequency questionnaire (FFQ), International Physical Activity Questionnaire (IPAQ), were used to assess dietary intakes of participants. The severity of COVID-19 was assessed based on the COVID-19 Treatment Guidelines (CTG). Satisfaction with Life Scale (SWLS) questionnaire was utilized to determine the level of life satisfaction. Outcomes including severity of COVID-19 symptoms, hospitalization, hypoxia, lung infection, need to respiratory support, duration of disease, recovery after hospitalization, serum levels of C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) and saturation of peripheral oxygen (SpO2) level were evaluated.

Among those recovered from COVID-19, there was an association between increased intake of nuts and reduction in CRP level (p=0.007), increase in life satisfaction score (p<0.001), decreased risk of severe infection of COVID-19 (p=0.036), decline in the need to respiratory support (p=0.002), decreased duration of disease (p=0.004), reduction in duration of recovery after hospitalization (p=0.001), declined risk of fever (p=0.048), lowered risk of weakness (p<0.001), chest pain (p<0.001), headache (p=0.028), dizziness (p=0.002) and anorexia (p=0.015).

Higher intake of nuts was shown to be correlated with a decreased risk of severe infection, hospitalization, and duration of illness, along with improvements in COVID-19 symptoms.

Introduction: 

This research intends to determine the occurrence of ADHD-related symptoms in children with Convergence Insufficiency (CI), a treatable visual issue that may be misconstrued as ADHD. It focuses on understanding how often these behaviors are noticed by parents and educators in various environments, such as home and school.

This was a case–control study and 108 children attended. Eye examinations were performed and the children were divided into the with CI and control groups. The Children Symptoms Inventory-4 (CSI-4) questionnaire was completed by teachers and parents. CSI-4 is a rating scale that screens for emotional and behavioral symptoms of childhood disorders. These questionnaires ask the parent and teachers to rate the frequency of behaviors observed: never, sometimes, fairly often, or most of the time.

A total of 108 school-aged children were evaluated by parents and 100 of them by the teachers. There were 51% girls in the CI group and 49% in the control group. Comparison of the mean scores of the parent questionnaire in CI group and control group in ADHD symptoms showed that these two groups did not have significant difference (P<0.05) in ADHD symptoms. The results of the teacher questionnaire indicated that these two groups had a significant difference (P<0.05) for inattention symptom.

The results from this study suggested that based on teacher information, CI children have a higher frequency of inattentive behaviors, compared to normal binocular children. ADHD may make diagnosis of CI difficult, exacerbate the symptoms of CI and vice versa. For children who have ADHD symptoms or other learning difficulties, a comprehensive visual examination can be useful for diagnosis of CI and other vision problems

 Kawasaki disease is an idiopathic febrile systemic vasculitis, recognized as the leading cause of acquired heart disease in pediatric patients. Gastrointestinal manifestations can lead to delayed treatment, underscoring the importance of identifying and predicting factors associated with these manifestations to enable timely intervention.

 The primary objective of this study was to identify the aforementioned factors.

 This retrospective study collected demographic information, medical history, physical examination findings, and laboratory results of 359 children suspected of having Kawasaki disease and referred to Mofid Children’s Hospital between 2013 and 2022. The study assessed the frequency of gastrointestinal manifestations and their association with physical examination findings and laboratory data.

 A total of 359 patients were included in the study, comprising 153 males and 206 females. The mean age of participants was 2.8 ± 2.6 years. Abdominal pain was the most common clinical manifestation, reported in 39% of patients. Elevated levels of aspartate aminotransferase (AST) were observed in 38.1% of patients, while 30.2% showed elevated alanine aminotransferase (ALT) levels, and 10.5% exhibited direct hyperbilirubinemia. Patients with elevated ALT and AST levels had a higher incidence of abdominal pain, nausea/vomiting, and anorexia. Moreover, patients with positive findings of red blood cell (RBC) and white blood cell (WBC) in their stool examination had a higher incidence of fever and abdominal pain.

 Based on our statistical analysis, elevated AST and ALT levels, hyperbilirubinemia, and positive stool findings of RBC and WBC appear to be predictive factors for gastrointestinal manifestations in Kawasaki disease.

 Lead (Pb) is a heavy metal that can harm major organs in humans, and its high serum levels can cause poisoning. In Iran, one of the major causes of Pb poisoning is opium consumption because drug dealers combine opium with henna, a plant extract color; Pb is added to this plant for the fixation of its color. Considering that henna makes opium heavier, it costs more, and none of the users can differentiate opium from henna as their color is the same. According to the statistics of the Iranian Ministry of Health and Medical Education, 2.3% of people between the ages of 15 and 60 are drug addicted, of whom 69% to 94% have opiate addiction. Regarding these issues, it seems necessary to study the serum level of Pb in Iranian addicts.

 The status of the serum Pb level and Pb poisoning symptoms among opium addicts was investigated in this study.

 In this study, all addicted patients were selected based on their history of using opium who were referred to the emergency department of Shahid Rajaei Hospital in Karaj (Center of Alborz province in Iran) and were evaluated between March 2016 and September 2016. Blood samples were collected from patients to measure serum Pb levels with atomic absorption by a Perkin device (USA) and evaluate basophilic stippling of red blood cells (RBCs) in a peripheral blood smear under a light microscope. The clinical signs and symptoms of patients were evaluated in several fields. They included neurological problems (including headache, memory impairment, sensory impairment, muscle weakness, seizure, and decreased consciousness), gastrointestinal (GI) problems (including constipation, nausea and vomiting, abdominal colic pain, and anorexia), and general signs and symptoms (including myalgia, fatigue, and the presence of a Pb line on the gum).

 During the study, 75 patients with opium addiction were enrolled, including 67 (89.3%) males and 8 (10.7%) females. The mean age of patients entering the study was 52 years. Of these patients, only one case (1.3%) used opium by inhalation, and the remaining 74 cases (98.7%) had oral addiction. The mean serum Pb level among these patients was 57.7 μg/dL (the lowest and highest levels were 0.2 and 193 μg/dL, respectively). Of these 75 patients, the serum level of 15 cases (20%) was less than 15 μg/dL, and that of 60 (80%) cases was greater than 15 μg/dL. Of all the patients, the one who had the highest serum levels of Pb (193 μg/dL) went through a seizure, lost consciousness, and died. In general, GI signs and symptoms were more common among patients than any other signs and symptoms.

 The findings of this study could reveal the most common complications of Pb poisoning in addicted patients, but no relationship was found between rare complications and Pb poisoning level.

 Crimean Congo hemorrhagic fever (CCHF) is a tick-borne, zoonotic disease distributed globally. As the clinical features of CCHF and COVID-19 are similar, getting an early and reliable diagnosis may be difficult.

 We report the first misdiagnosed case of CCHF in the setting of a COVID-19 pandemic from Ravansar County of Kermanshah province in Iran. Our patient was initially misdiagnosed with COVID-19, got hospitalized, but later tested positive for CCHF. However, the delay in diagnosis caused her death.

 Crimean Congo hemorrhagic fever should be considered among people in endemic areas who show COVID-19 symptoms for urgent medical attention.

Spiritual coping strategies of patients are influenced by their mood/anxiety symptoms and emotional schemas. Therefore, the present study aimed to develop a conceptual model of spiritual coping in patients with chronic back pain, considering the role of mood/anxiety symptoms and emotional schemas.

The research method was descriptive correlational. The statistical population included all women and men 25 to 55 years old with chronic back pain referring to the orthopedic and neurology clinics of Torbat Heydarieh City, Iran, in 2021-2022, of whom 400 people were selected considering the inclusion criteria using the convenience method. The tools used were the mood and anxiety symptoms questionnaire (MASQ-D30), a brief version of the Leahy emotional schema scale II-(LESS II), and the religious coping scale. The data were analyzed by structural equation modeling by SPSS software, version 24 and LISREL software, version 8.8.

The fitted model showed a direct relationship between mood/anxiety symptoms and emotional schemas (β=0.740), an inverse relationship between mood/anxiety symptoms and spiritual coping (β=-0.480) at the significant level of 0.05, and an indirect relationship between mood/anxiety symptoms and spiritual coping through emotional schemas (β=-0.488), which was significant at the 0.05 level.

The results of the study supported the mediating role of emotional schemas in the relationship between mood/anxiety symptoms and spiritual coping strategies of patients with chronic back pain. Therefore, developing therapeutic interventions to reduce emotional schemas and improve spiritual coping strategies along with medical treatments is useful in adapting and improving chronic pain sufferers

Clinical prediction plays a vital role in clinical care, as it informs healthcare professionals, patients, and their relatives of the possible disease outcome, helping them to make a medical decision and improve health outcomes, if possible. Much more credit is often given to a physician for a correct prognosis than for the acute diagnosis or skilled treatment that underlies his statement about the course of the disease and its termination. Hippocrates established medicine as a scientific profession based on clinical observation and rational inquiry. Hippocrates and his followers focused more on prognosis than diagnosis. He mastered the art of prognosis based on the patient’s signs and symptoms of diseases. The Book of Prognostics is a treatise attributed to him and fully dedicated to this prognostic approach. This book alone is sufficient to prove his greatness in terms of medical care and the art of healing. In this paper, his prognostic approach toward diseases with the help of signs and symptoms will be explored.

Since the emergence of COVID-19 disease and its spread, many people have been globally infected. Also, evidence has shown that some specific conditions and underlying diseases result in more severe symptoms in the patients. Therefore, this study aimed to investigate the relationship between demographic characteristics and underlying conditions with symptoms in patients with COVID-19 in one of Iran's major hospitals.

The present cross-sectional and descriptive-analytical study was conducted from February 20th, 2020 to August 20th, 2021. The sampling method was census. The data were collected from the statistics department, medical records, HIS, and they were analysed via SPSS software version 25 using descriptive statistics and statistical tests such as Spearman, Mann-Whitney, and Chi-square.

Among the 7,236 patients with a definite diagnosis of COVID-19, most (53.2%) of the subjects were men and the total death rate was 8%. There was a positive correlation (p-value=0.000) between age and length of stay. About 69% of the patients had symptoms related to the disease in their CT scan and 39.5% had an oxygen level of less than 93%, which roughly 2.6% of them were intubated. There was a significant relationship between patients' age, sex, and length of stay with their discharge status, first symptoms of disease, and patient’s underlying conditions. Also, there was a significant difference in patients' discharge status based on having some early symptoms, gastrointestinal symptoms, and underlying conditions.

The findings of this study emphasize the importance of early detection and management strategies, especially for individuals with specific risk factors. These insights are crucial in guiding healthcare practices and policies to effectively combat the ongoing pandemic. Also, the study outcomes provide valuable insights for healthcare professionals and policymakers, aiding in the development of targeted interventions and patient-centered care protocols.

COVID-19 has been announced as an international public health emergency since February 2020 by the WHO.

The present study aimed to identify clinical manifestations and laboratory findings of COVID-19 patients and their relationship with severe outcomes.

This cross-sectional study with descriptive and analytical purposes was conducted on 470 patients suspected of having COVID-19 infection hospitalized at Ganjavian hospital, one of the Referral Hospitals for COVID-19 patients, in Dezful, Iran. Patients’ records were reviewed for demographics and clinical manifestations, and the results of laboratory tests and serious outcomes from April to June2020were reviewed. The admission criterionwasa definitive coronavirus infection diagnosis, andthe exclusion criteria were the medical records of patients who underwent three follow-up test appointments for any reason. Data were analyzed using SPSS version 22.0.

The mean age of patients was 56.05. The most prevalent symptoms among COVID-19 patients were dry cough, fever, and respiratory complications. The most significant laboratory findings were between the first and third test appointments in WBC, MCV,MCHC, HB, PLT, CRP, ESR, BUN, CR, LDH, and SGPT (P < 0.001). Age, fever, nausea, chills, underlying disease, and some laboratory factors with severe COVID-19 outcomes (ICU admission and death) had a significant relationship.

Considering the main clinical manifestation of COVID-19, such as dry cough, fever, and dyspnea (need for oxygen) also, results of laboratory tests such as Hb and RDW can have a key role in preventing of serious outcome and covid-19 moratality rate.

 Colorectal cancer (CRC) is the third most prevalent cancer in Iran. This study aimed to assess the level of awareness regarding CRC warning signs, risk factors, screening program, and related factors among adults in North-Eastern Iran.

Study Design: 

A cross-sectional study.

 The multi-stage sampling method was used to survey 2614 participants attending primary healthcare centers in Mashhad, Iran. The data collection tools were the demographics section and Bowel/ CRC Awareness Measure (Bowel/Colorectal CAM). The data were analyzed by SPSS, version 25. The significance level of the data analysis was less than 0.05.

 Mean awareness for CRC warning signs and CRC risk factors were 2.85±2.13 and 3.63±1.85, respectively. Most participants (97.2%) had no awareness of the CRC screening program. There was a significant association between marital status, education, job, income, and family history of CRC with awareness of warning signs (P<0.001); moreover, there was a significant association between age, education, job, income, and family history of CRC with awareness of risk factors (P<0.001). The results of logistic regression indicated that there was a significant association between age (P=0.022, OR=1.794, 95% confidence interval [CI]: 1.087, 2.962), gender (P=0.005, OR=0.488, 95% CI: 0.296, 0.803) and warning sign awareness (P<0.001, OR=1.278, 95% CI: 1.124, 1.454) with awareness of the CRC screening program.

 In this study, most of the participants had low awareness of CRC. More aimed educational interventions are needed to promote Iranian adults’ awareness of CRC.