Iranian Journal of Medical Sciences
Volume:45 Issue: 3, May 2020

The outbreak of Coronavirus disease 2019 (COVID-19) has posed a significant threat to many countries. Since the disease does not currently have a particular treatment, there is a compelling need to find substitute means to dominate its expansion. In this rapid review, we aimed to determine some countries’ public responses to the COVID-19 epidemic.

In this study, academic databases, including MEDLINE, Scopus, and Embase, were investigated. The keywords applied in the search strategy besides the names of each country were: “Public Health,” “Public Response”, “Health Policy”, “COVID-19”, “Novel Coronavirus,” “2019-nCoV”, and “SARS-COV-2”. The countries included China, Italy, Iran, Spain, South Korea, Germany, France, United States, Australia, Canada, Japan, and Singapore.

The total number of retrieved articles in MEDLINE, Scopus, and Embase in April 2020 was 594, and after removing 259 duplicate articles, 335 papers were screened by the experts. After this investigation, 50 articles, in addition to 12 webpages, were extensively reviewed for the results section. Public health strategies and responses can be divided into four main areas, including monitoring, public education, crowd controlling, and care facilities.

According to the results of the management decisions of some governments on quarantining, social isolation, screening methods, and flight suspensions due to the severity and anonymity of COVID-19, it is highly assured that these strategies would be the most successful approaches to confront the present pandemic. Governments should put in place timely and strict measures to halt the spread and diminish its unintended deadly consequences.

Continuous positive airway pressure (CPAP) is the gold standard therapy for treating obstructive sleep apnea (OSA) disorder. However, patients’ adherence to its regular use is poor. The present study aimed to determine the adherence rate to CPAP therapy by identifying factors affecting its regular use and its associated problems and discomforts among a sample population in Mashhad (Iran). The study was conducted from October 2017 to March 2018 in Mashhad (Iran) using both quantitative and qualitative methods. The quantitative study was carried out using a retrospective cross-sectional data collection from five sleep clinics and one CPAP sales office. The patients were classified into an adherent and a non-adherent group to determine the factors affecting CPAP adherence. Quantitative data were analyzed using SPSS software (version 22.0). Additionally, a prospective qualitative study was performed through a series of telephone interviews using the content analysis method. Qualitative data were analyzed using MAXQDA 10 software. In the quantitative study, the medical records of 159 patients were used, out of which 79 (49.6%) were non-adherent to CPAP therapy. The mean age of all patients was 56.9±9.8 years. The mean body mass index, apnea-hypopnea index, and Epworth sleepiness scale (ESS) scores were 30.9±6.6 kg/m2, 37.2±28.1 events/hour, and 10.4±5.5, respectively. At baseline, the adherent group had a significantly higher age (P=0.006), higher oxygen desaturation index (P=0.006), and lower ESS (P=0.023) compared to the non-adherent group. In the qualitative study, a total of 29 telephone interviews were held with patients from the non-adherent group (8 women and 21 men). Analysis of the interviews resulted in three main categories (level of knowledge, discomfort, and costs) and nine sub-categories. A high percentage of OSA patients had poor adherence to CPAP therapy. Device-related issues could be adequately resolved by providing complementary information during follow-up visits. Moreover, efforts to reduce costs through comprehensive insurance coverage or with government subsidy would improve patients’ adherence to CPAP therapy.

Handwriting problems are one of the common problems among students in the early years of education. The current study aimed to determine further validation aspects of the Persian Handwriting Assessment Tool (PHAT) in primary school-aged children. The current methodological study was conducted on 452 healthy 8-10-year-old students in Tehran, Iran, selected via random cluster sampling method. Inclusion criteria were native Persian-speaking and no documented physical and mental impairments. Construct and structural validities were established by exploratory factor analysis (EFA) using principal axis factoring with Promax rotation and confirmatory factor analysis (CFA), respectively. Criterion validity was examined by expert opinion as the gold standard using Pearson correlation test. Internal consistency, test-retest, and inter-rater reliability were examined using Cronbach’s alpha and intra-class correlation (ICC). Test-retest had a seven-day interval. The EFA results indicated two separate factors in the copying and dictation domains. Speed and orthographic error and size were considered as separate items. The CFA confirmed the factor structure. Criterion validity revealed low to moderate correlation (formation: 0.548, P<0.001; 0.503, P<0.001, spacing: 0.553, P<0.001; 0.307, P=0.030, alignment: 0.442, P<0.001; 0.358, P=0.011, size: -0.376, P=0.007; -0.445, P<0.001, and slant: 0.360, P=0.010; 0.372, P=0.008) in copying and dictation domain, respectively. Acceptable internal consistency (Cronbach’s alpha: 0.72-0.99), excellent test-retest (ICC: 0.76-0.99), excellent inter-rater reliability between teachers (ICC: 0.86-0.95), and good to excellent inter-rater reliability between teachers and the occupational therapist (ICC: 0.60-0.95) were reported. The results indicated that the PHAT was a valid and reliable tool for assessing handwriting in primary school-aged children.

Sperm cryopreservation-thawing process has damaging effects on the structure and function of sperm, namely cryoinjury. Calcium overload has been reported as a postulated mechanism for sperm damage during the first steps after thawing. This study was designed to assess the intracellular calcium (Ca2+i) after cryopreservation and to clarify the role of a calcium chelator ethylene glycol-bis (2-aminoethyl ether)-N, N, N′, N′-tetraacetic acid (EGTA) on human sperm quality. Forty semen samples were obtained from fertile men (March 2017 to 2018). The samples were randomly divided into fresh (F) and cryopreserved-thawed (CT) groups. The F and CT samples were divided into control and 1 mM EGTA-treated groups. Sperm kinematics and membrane integrity were assessed. The reactive oxygen species (ROS) and adenosine triphosphate (ATP) were measured by luminescent methods. Ca2+i, apoptotic rate, and mitochondrial membrane potential (MMP) were evaluated using flow cytometric methods. Data were compared using SPSS software, version 16.0 by ANOVA and Kruskal-Wallis test. P<0.05 was considered as significant. Cryopreservation decreased sperm motility, viability, membrane integrity, Ca2+i, MMP, and induced cell apoptosis and ROS production. EGTA could not protect the cryopreserved sperm from cryoinjury. It was found to have destructive effects on fresh sperm motility and viability (P=0.009) relative to cryopreserved sperm. ATP was reduced (P=0.02) and ROS production (P=0.0001) was increased in the EGTA-treated F and CT sperms. Despite Ca2+i reduction by EGTA, it had no protective effects on fresh or cryopreserved sperm. We concluded that sperm cryoinjury was not dependent on calcium overload, and it was suggested that cryoinjury was mainly related to cell membranes damage.

Heracleum persicum (H. persicum) is a medicinal herb used in Iranian traditional medicine for its anti-toxic property. It is commonly consumed in the form of food additives and as a medicinal herbal tonic to treat liver and kidney diseases. The present study aimed to investigate the anti-oxidant, anti-diabetic, and anti-hyperlipidemic effects of H. persicum hydroalcoholic extract in alloxan-induced diabetic rats.

Adult male Wistar rats (n=30) were assigned to five groups: a normal group, a diabetic control group, and three diabetic groups treated orally with 200 and 400 mg/kg of the extract and 5 mg/kg of glibenclamide, respectively, for two weeks. Blood glucose and bodyweight were measured at the end of each week. On day 15, blood samples were collected to measure the levels of insulin, insulin growth factor-I (IGF-I), antioxidant markers for malondialdehyde (MDA), glutathione peroxidase (GPx), superoxide dismutase (SOD), total antioxidant activity (TAS), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) using commercial kits. The data were analyzed using SPSS Software (version 22.0).

Daily treatment with 400 mg/kg of the extract significantly reduced the blood glucose level (P<0.001) and improved bodyweight (P=0.002), insulin (P<0.001), IGF-I (P=0.024), SOD (P=0.001), GPx (P=0.009), MDA (P<0.001), TAS (P=0.006), TG (P<0.001), HDL (P=0.023), LDL (P=0.005), and VLDL (P<0.001) compared with the diabetic control group.

Beneficial effects of H. persicum for the treatment of diabetes were confirmed.

Persian Medicine is one of the oldest and richest complementary and alternative options in the field of medicine and has a comprehensive medical system. Henna oil is recommended in Persian Medicine for the treatment of numerous women’s diseases such as cervicitis. To date, henna has been used for many medical purposes, including astringent, bleeding, cardioinhibitory, hypotension, and relaxation. Accordingly, the present study aimed to provide the formulation of a henna-oil-based vaginal suppository and examine its physicochemical and antimicrobial properties. The present study was approved and performed in accordance with the regulations of Research Council, Kerman University of Medical Sciences, Kerman, Iran, in July 2016. Different percentages of henna oil, glycerin, and gelatin, as well as henna oil and polyethylene glycol 400 and 4000, were mixed to achieve a formulation with proper appearance features and, particularly, without any oil leakage from the suppository surface. Uniformity of weight, uniformity of content, disintegration time, and dissolution test of the suppositories were evaluated. The growth-inhibiting activity of the suppositories and aqueous extract of henna was evaluated against bacteria, including the Gram-positive bacterium Gardnerella vaginalis, Neisseria gonorrhoeae, and group B streptococcus. The formulations had a smooth appearance without any cracks or fractures. Disintegration times for glycero-gelatin and polyethylene glycol suppositories were 60 and 10 min, respectively. 40% of the drug was released from polyethylene glycol suppositories after 60 min, but glycero-gelatin suppositories had no release after three hours. Minimum inhibitory concentration (MIC) of suppositories and aqueous extract were 0.4 mg/mL and 0.01 mg/mL, respectively. Polyethylene glycol suppositories had acceptable physicochemical properties, and the henna extract and suppositories inhibited the three studied pathogens.

Inflammatory bowel disease (IBD), of which Crohn’s disease (CD) and ulcerative colitis (UC) are the two main clinicopathological subtypes, is a group of digestive system diseases of unknown etiology. Risk factors for IBD are environmental factors, genetics, and immune system agents. Mycobacterium avium subspecies paratuberculosis (MAP) is one of the most important infectious factors and a suspected cause of IBD. The present study aimed to determine the prevalence of MAP in both IBD patients and non-IBD people as well as to investigate the relationship between the presence of this bacterium and IBD. A cross-sectional study was conducted during May-December 2017 among 146 IBD patients (32 with CD and 114 with UC) at the Motahari Clinic affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. For comparison, the blood samples of 146 non-IBD volunteers (the control group) were tested for the presence of MAP using the polymerase chain reaction method (specific IS900 fragment). The data were analyzed using the SPSS software (version 19.0). The Kolmogorov-Smirnov test was used to evaluate the normal distribution of variables. The χ2 test was used to compare the qualitative variables between the groups. MAP was present in 104 (71.2%) IBD patients out of which 24 (75%) had CD and 80 (70.2%) had UC. In the control group, MAP was present in 63 (43.2%) non-IBD volunteers. There was a significant association between the presence of IBD and MAP (P<0.001). A high prevalence of MAP was observed in the South of Iran. MAP DNA was detected in the blood samples of CD and UC patients as well as non-IBD volunteers. The high prevalence of MAP indicated a possible role of MAP in stimulating IBD.

Hydatid disease (HD) is an infectious disease caused by echinococcosis. Hydatid cyst (HC) most commonly invades the liver (60-70%) and the lungs (20-25%). However, other parts of the body and even unusual locations can be infected, mimicking a benign lesion that could be easily missed. Primary HC of the chest wall is extremely rare, even in countries where echinococcosis is endemic. We herein present a case of a 40-year-old man with a right-sided growing thoracic wall mass. The patient did not present the relevant history (living in rural areas or being in contact with farm animals) and the serological examination with the indirect hemagglutination test was negative. During surgery, a cystic mass between the eleventh and twelfth ribs was observed. The thoracic wall mass extended to the posterior abdominal wall and was entirely extrapulmonary and extraperitoneal. All cystic structures of the thoracic wall and intrathoracic region were removed, and the primary defect was reconstructed. In endemic areas such as Iran, HD should be considered in the differential diagnosis of mass lesions located in the chest wall or other parts of the body, even without the relevant history or serologic evidence.