International Journal of Preventive Medicine
Volume:14 Issue: 5, May 2023

As the population of patients recovering from COVID‑19 grows, post COVID‑19 challenges are recognizing by ongoing evidences at once. Long COVID is defined as a syndrome with a range of persistent symptoms that remain long after (beyond 12 weeks) the acute SARS‑CoV‑2 infection. Studies have shown that long COVID can cause multi‑organ damages with a wide spectrum of manifestations. Many systems, but not limited to, including respiratory, cardiovascular, nervous, gastrointestinal, and musculoskeletal systems, are involved in long COVID. Fatigue and dyspnea are the most common symptoms of long COVID. Long COVID‑19 may be driven by tissue damage caused by virus‑specific pathophysiologic changes or secondary to pathological long‑lasting inflammatory response because of viral persistence, immune dysregulation, and autoimmune reactions. Some risk factors like sex and age, more than five early symptoms, and specific biomarkers have been revealed as a probable long COVID predicator discussed in this review. It seems that vaccination is the only way for prevention of long COVID and it can also help patients who had already long COVID. Managing long COVID survivors recommended being in a multidisciplinary approach, and a framework for identifying those at high risk for post‑acute COVID‑19 must be proposed. Possible therapeutic options and useful investigation tools for follow‑up are suggested in this review. In sum, as evidence and researches are regularly updated, we provide the current understanding of the epidemiology, clinical manifestation, suspected pathophysiology, associated risk factors, and treatment options of long COVID in this review.

Patients with inflammatory bowel disease (IBD) suffer from a wide range of comorbidities such as migraine. In studies, the prevalence of migraine in cases with IBD was reported differently. The goal of this systematic review and meta‑analysis was to estimate the pooled prevalence of migraine in IBD cases.

Two researchers independently and systematically searched PubMed, Scopus, EMBASE, Web of Science, and google scholar. They also searched the gray literature including references of the included studies and conference abstracts which were published up to May 2021. Cross‑sectional studies were included.

The literature search revealed 840 articles, and after deleting duplicates, 650 remained. For the meta‑analysis, 10 studies were included. Totally, 62,554 patients were evaluated. The pooled prevalence of migraine in patients with IBD was 19% (95% CI: 15–22%). The pooled prevalence of migraine in ulcerative colitis (UC) was 10% (95% CI: 4–15%) (I2 = 99.8%, P < 0.001). The pooled prevalence of migraine in the Crohn’s disease (CD) group was 24% (95% CI: 17–30%) (I2 = 98.8%, P < 0.001). The pooled odds of developing migraine in IBD cases was 1.51 (95% CI: 1–2.27) (I2 = 90.8%, P < 0.001).

The result of this systematic review and meta‑analysis showed that the pooled prevalence of migraine in patients with IBD was 19% (95% CI: 15–22%).

The authorities recently emphasized the importance of dietary control for COVID‑19 patients in hospitals. However, there is limited detail about the obesity and death of COVID‑19 patients who are hospitalized in the Asian and Western countries. The aim of this study was to find the role of obesity and mortality of the hospitalized COVID‑19 patients. A systematic review of the studies on obesity and mortality of hospitalized COVID‑19 patients in the Asian and western countries.

Databases of ProQuest, PubMed, and EBSCO were used to find relevant articles published between January 2020 and March 2021. A total of 3,70,836 patients in 17 studies were included.

We found significant correlation between obesity and mortality in hospitalized COVID‑19 patients (pooled odds ratio [POR] = 1.28, 95% CI: 1.23– 1.33). In particular, this study demonstrated that the Asian countries had higher POR (1.44, 95% CI: 1.16–1.79) compared to the western countries (1.28, 95%CI: 1.23‑1.33). The heterogeneity calculation showed heterogenous among studies included (I2 > 50%).

The mortality of COVID‑19‑hospitalized patients is related to obesity, which requires a multi‑stakeholder mitigation approach to avoid and control obesity and its impacts.

Due to lack of contemporary data on the presentation, management, and mortality of acute coronary syndrome (ACS) admissions in Iran, in this prospective registry study, we aimed to evaluate the presentation, management, and mortality as the outcome of patients with ACS in Isfahan, Iran, 2001–2016 to address treatment and healthcare depletions.

Data of 62,276 patients admitted with the diagnosis of ACS from 2001 to 2016 prospectively were obtained by Surveillance Unit of Isfahan Cardiovascular Research Center, Isfahan, Iran, in 13 hospitals of Isfahan province. We evaluated data on presentation, management, and in‑hospital and 28‑day mortality.

Nearly half of the patients ranged in age from 51 to 70 years (32050, 51.5%), which did not differ among ACS types (ST‑segment myocardial infarction (STEMI): 53.9%; non‑STEMI: 53.4%; unstable angina: 51.9%). In‑hospital, anti‑platelets use was high (84.9%). Thrombolytic were used in 48.1% of STEMI, 3.8% of non‑STEMI, and 1.1% of unstable angina. Discharge medication rates were suboptimal. In‑hospital and 28‑day mortality were highest for STEMI (6.5 and 12.6%, respectively).

These data represent the large ACS registry in Iran. Data revealed the various presentations of ACS and demonstrated opportunities for improving ACS management by focusing on increasing use of recommended drugs especially after discharge due to suboptimal medical treatment in these patients. The high mortality rate needs to be taken into consideration in ACS patients.

Equitable distribution of health care sector resources is one of the most important goals of health systems in all countries. The purpose of this study is to measure equity of geographical distribution of active specialist physicians in Iran’s health system.

The present study was a descriptive‑cross‑sectional. The statistical population included: all active specialist physicians working in the public, private, social insurance organization, military, charity, and the other health service providers in Iran in 2019. Studied demographic data were collected from Iran’s national statistic center. Also, information of specialist physicians was obtained from several databases. Finally, duplicated records were removed, and the number of specialist physicians extracted. Data analysis was performed using Stata V.16 and ArcGIS 10.4 software.

The results showed that the number of specialist physicians per 100,000 population who worked in Iran’s health system was 46.81. The provinces of Tehran had the highest and Sistan and Baluchestan had the lowest number of specialist physicians. Also, 52.63% of active specialist physicians provide health services in four provinces, whereas these provinces are 37.13% of the country’s population. Total Gini coefficient of the distribution of active physicians in Iran in 2019 was 0.23.

Distribution of specialist physician was different but somewhat equitable in the provinces. However, in some provinces, the ratio of specialist physicians to the population was still low. Therefore, when the number of specialist physicians increased, their distribution should be considered concurrently.

Diclofenac (DIC) is an NSAID that can cause toxic effects in animals and humans and carvacrol (CAR) is a monoterpene compound that displays effective pharmacological and biological actions. The purpose of this work was to assess the influences of CAR on DIC‑induced liver injury and oxidative stress in male rats.

The male Wistar rats were segregated into four groups. Group 1, the control group; Group 2 received DIC‑only (10 mg/kg BW, p.o); Group 3, received CAR‑only (10 mg/kg BW, p.o), and group 4 received DIC plus CAR. The serum levels as well as the activity of several liver‑associated markers, and oxidative and anti‑oxidant compounds were tested. The expression of pro‑inflammatory mediators was also studied using the qRT‑PCR analysis.

Our results showed that DIC treatment was associated with the elevation in the serum levels of liver‑related markers together with the increase in the serum and the hepatic levels of malondialdehyde (MDA) and protein carbonyl (PC). Moreover, DIC reduced the activity of the antioxidant system in the rats and increased lymphocyte infiltration into the hepatocytes. CAR; however, protected the hepatocytes from the toxic effects of DIC by enhancing the activity of antioxidant enzymes such as catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), and Glutathione (GSH). By diminishing the expression of tumor necrosis factor (TNF)‑α, CAR was also capable of preventing the inflammatory effects of DIC on liver cells.

The findings of this study indicated that the administration of CAR could alleviate the noxious effects of DIC on the antioxidant defense system and liver tissue.

Cardiovascular diseases (CVDs) are recognized as one of the leading causes of death worldwide. Studies have shown the impact of genetic predisposition and dietary factors on developing these diseases. Dietary patterns and genetic factors such as polymorphisms related to the level of adiponectin may also interact with each other and produce variances in the effects of these factors on different individuals. The purpose of this study is to investigate the interactions between food intake patterns and polymorphisms on ADIPOQ and ARL15 genes in relation to cardiometabolic risk factors.

This cross‑sectional study is conducted on 380 adults (20 to 70 years old) living in Yazd, Iran. Individuals were selected from the participants in Yazd Health Study (YaHS) and its sub‑study called Taghziyeh Mardom‑e Yazd (TAMYZ) after reviewing the inclusion and exclusion criteria. YaHS is a population‑based cohort study which has been conducted on 9962 adults living in Yazd since 2014. In the present study, rotated principle component analysis (PCA) with Varimax rotation is used to identify the major dietary patterns. The polymerase chain reaction‑restricted fragment length polymorphism (PCR‑RFLP) method is used in order to identify rs1501299 and rs6450176 variants (on ADIPOQ and ARL15 genes, respectively). General linear models (GLM) as well as regression models are used to investigate the interactions between the studied genotypes and the extracted dietary patterns.

The results of this study can help to personalize dietary recommendations for the prevention of CVDs according to the genetic predisposition of individuals.

The alteration of DNA cytosine methylation is one of the most common epigenetic changes that can play a significant role in human cancers. The enzymes involved in DNA methylation of promoter regions of the genes are DNA methyltransferases (DNMTs). The therapeutic activities and apoptotic effects of DNA methyltransferase inhibitors (DNMTIs) have been reported in various cancers. This study was assigned to assess the effect of zebularine on intrinsic and extrinsic pathways, DNAT 1, 3a, and 3b, p21, and p53, viability, and apoptosis in hepatocellular carcinoma (HCC) cell lines.

Hepatocellular carcinoma cell lines (HCCLM3, MHCC97H, and MHCC97L) were purchased from the National Cell Bank of Iran, Pasteur Institute, treated with zebularine, and the MTT assay was performed. Then, flow cytometry assay and real‑time RT‑PCR analysis were performed with zebularine. Statistical comparisons between groups were made using GraphPad Prism software version 8.0. A significant difference was considered as P < 0.05.

Zebularine up‑regulated DR4, DR5, FAS, FAS‑L, TRAIL, Bax, Bak, Bim, p21WAF/CIP1 (p21), and p53 and down‑regulated DNMTs (DNAT 1, 3a, and 3b), Bcl‑2, Bcl‑xL, and Mcl‑1, significantly resulting in apoptosis induction in HCC cell lines. Maximal and minimal apoptosis was seen in HCCLM3 and MHCC97L cell lines, respectively.

Our findings indicated that DNMTI zebularine can induce apoptosis and inhibit cell growth through both pathways (extrinsic and intrinsic) in HCC cell lines HCCLM3, MHCC97H, and MHCC97L.

Food waste reflects inadequate food intake and is of economic and environmental importance. Therefore, understanding the underlying factors is a must to combat food waste.

A qualitative study was conducted using semi‑structured interviews with managers, nurses, nutritionists, food providers, kitchen staff, and inpatients at three hospitals in Tehran. Responses were recorded, coded, and analyzed thematically.

Forty‑eight face‑to‑face interviews led to three core categories: 1. opinions/performance; 2. causes, related factors, and characteristics; and 3. rooting and suggestions. We found that the majority of the hospitalized patients did not consume their entire food. In spite of overall satisfaction with the quantity and quality of food, anorexia, personal taste, and poor quality of raw materials prohibited patients from eating. Also, rice was the most discarded food. Economic barriers were the most important hindrance to elevate the quality, and some strategies, like the supply of high‑quality materials and recruiting skillful cooking team, were proposed to improve it.

Our findings delineated a limited budget as the main barrier to improve the quality. Nevertheless, the low quality of hospital foods may actually impose a heavier economic burden due to food waste.

Both aging and diabetes are two well‑established risk factors related to type 3 diabetes and memory deficits. Accordingly, diabetes multiplies the effects of aging on cognition impairments once these conditions occur simultaneously.

In this present experimental study, 56 male Wistar rats with HFD/STZ‑induced T2D were randomized into seven groups (n = eight animals per group): (1) sedentary old non‑diabetic (C); (2) sedentary HFD/STZ‑induced T2D (D); (3) sedentary HFD/STZ‑induced T2D plus UA (UA) (DU); (4) endurance‑trained HFD/STZ‑induced T2D (DE); (5) resistance‑trained HFD/STZ‑induced T2D (DR); (6) endurance‑trained HFD/STZ‑induced T2D plus UA (DEU); and (7) resistance‑trained STZ‑diabetic plus UA (DRU) rats. Two‑way ANOVA was applied to measure the training, supplementation, and interaction effect on serum and gene expression outcomes.

The study results established no significant interaction effect between the UA supplementation and the resistance/endurance training with regard to the levels of glucose (P = 0.534), insulin (P = 0.327), brain‑derived neurotrophic factor (P = 0.191), and insulin‑like growth factor‑1 (P = 0.448).

To develop novel practical nutritional strategies involving UA intake, further studies are thus needed to clarify how chronic consumption of UA with/without resistance/endurance training reverses cognition disorder process in old male Wistar rats with HFD/STZ‑induced T2D.

Diabetes has become an important health problem in the world. Natural agents, with antidiabetic property, are potential candidates for improving diabetes. Urtica Dioica Distillate (UDD) or Araghe Gazaneh is widely used for the treatment of diabetes as per traditional medicine. Despite the tremendous use of UDD as an antidiabetic compound in folk medicine, the antidiabetic effects of UDD has been neglected by medical scientists. In this study, we aimed to evaluate the effects of UDD on the glucose metabolism in diabetic rats.

A total of 24 male rats were divided equally into four groups, two treatment and two control groups, each containing normal or Streptozotocin (STZ)–induced diabetic rats. During 4 weeks, control and treatment rats received water or UDD, respectively. Fasting blood sugar (FBS), HbA1c, serum creatinine, blood urea nitrogen, and specific activities of hepatic enzymes including glucokinase (GK), hexokinase (HK), glucose‑6‑phosphate dehydrogenase (G6PD), and muscle glucose transporter type 4 (GLUT4) and liver phosphoenolpyruvate carboxykinase (PEPCK) mRNA levels were measured.

FBS and HbA1c increased in diabetic groups. Treatment with UDD significantly lowered FBS and prevented weight loss. Decreased FBS level was associated with higher activity levels of GK and HK in UDD‑treated diabetic rats. G6PD‑specific activity decreased in diabetic control rats compared to nondiabetic ones, but UDD treatment improved it to the normal levels. A significant decrease in the expression level of GLUT4 was observed in diabetic control rats compared to nondiabetic ones, but UDD increased it to the normal levels.

These findings suggest that UDD might exert therapeutic effects against diabetes by improving glucose metabolism and can be used as an alternative or complementary medicine for the treatment of diabetic patients.

Lipid disorder is a modifiable risk factor for diseases related to plaque formation in arteries such as heart attack, stroke, and peripheral vascular diseases. Identifying related factors and diagnosis and treatment in time reduces the incidence of non‑communicable diseases (NCDs). The aim of this study was to determine factors associated with lipids based on a national survey data.

Data of 16757 individuals aged 25–64 years obtained from the Iranian STEPwise approach to NCD risk factor surveillance (STEPs) performed in 2016, through multistage random sampling, were analyzed. Because of clustered, hierarchical, and skewed form of the data, factors related to total holesterol (TC), triglycerides (TG), low‑density lipoprotein‑cholesterol) (LDL-C), high‑density lipoprotein‑cholesterol) (HDL-C), TG/HDL‑C, TC/HDL‑C, and LDL‑C/HDL‑C were determined applying multilevel quantile mixed model. Parameters of the model were estimated on the basis of random effect of the province as well as urban or rural area for 10th, 25th, 50th, 75th, and 90th quantiles. Statistical analyses were performed by R software version 4.0.2.

Significant relationship was found between age, body mass index (BMI), waist circumference (WC), diabetes, hypertension, smoking, physical activity, education level, and marital status with TC, LDL‑C, HDL‑C, LDL‑C, and LDL‑C/HDL‑C. With increasing BMI and WC, subjects had higher levels of serum lipids, especially in higher quantiles of lipid levels. Lipid levels were significantly increased among smokers and those with diabetes or hypertension. The random effects were also significant showing that there is a correlation between the level of lipids in provincial habitants as well as urban and rural areas.

This study showed that the effect of each factor varies depending on the centiles of the lipids. Significant relationship was found between sociodemographic, behaviors, and anthropometric indices with lipid parameters.