Annals of Military and Health Sciences Research
Volume:21 Issue: 3, Sep 2023

Context: 

Several reports have been presented regarding the occurrence of acute myocardial infarction following vaccination against COVID-19.

The current systemic review tried to review and summarize the published evidence and documents regarding the occurrence of myocardial infarction following various types of anti-COVID-19 vaccines (AstraZeneca and Pfizer) and, finally, take steps to clarify the causes of such incidents.

The relevant databases, including Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane, were comprehensively searched by the two blinded researchers for all eligible studies based on the considered keywords. Of 76 articles initially collected by database searching, 20 articles were included in the last analysis.

The occurrence of acute myocardial infarction was mostly related to SARS-CoV-2-based messenger RNA and viral vector vaccines. This cardiac attack occurred after the first vaccination in 74% of patients affected. The time of occurrence of myocardial infarction was also very different between different types of vaccines and varied between 15 minutes and 21 days after vaccination. Most of the myocardial infarctions that occurred after vaccination were of the ST-segment elevation type (STEMI) (23 of 28 patients). More than two-thirds of myocardial infarction cases occurred in patients who had significant cardiovascular risk profiles (hypertension, diabetes mellitus, and ischemic heart disease). Overall, 22.2% of cases suffering post-vaccination myocardial infarction died within hospitalization.

The occurrence of myocardial infarction following the vaccination against COVID-19 is rare, and due to the fatality of this event, it is necessary to modify the biotechnological production of existing vaccines and to accurately evaluate the pathophysiology of this event.

Context: 

Nowadays, botulinum toxin is used for migraine prophylaxis, and a wide range of adverse effects (AEs) are reported after administration.

The present study was conducted to evaluate the safety profile of botulinum toxin for migraine headache prophylaxis.

Migraine Disorder, Disorder AND Migraine, Headache AND Sick, Headache AND Migraine, Migraine, Migrainosus, Migraine Headache, Migraines, Sick Headaches, Botulinum, Toxins AND Botulinum, Botulinum AND Neurotoxins, Toxins AND Clostridium Botulinum Neurotoxins, Botulinum Toxin, Botulinum Neurotoxin, Clostridium Botulinum Toxins, and Botulin were searched in PubMed, Scopus, EMBASE, Web of Science, and Google Scholar databases, and gray literature, including references of the studies published before April 2023.

We found 3081 articles by literature search; after deleting duplicates, 1711 remained. Thirty-five articles remained for meta-analysis. The pooled prevalence of musculoskeletal weakness in the head and neck regions was 4% (95% CI: 2-5%) (I2 = 92.2%, P < 0.001). The pooled prevalence of neck pain was 6% (95% CI: 4-7%) (I2 = 95.8%, P < 0.001). The pooled prevalence of blepharoptosis was 2% (95% CI: 2-3%) (I2 = 91.1%, P < 0.001). The pooled prevalence of facial paralysis was 2% (95% CI: 1-4%) (I2 = 94.1%, P < 0.001). The pooled prevalence of injection site pain was 4% (95% CI: 2-5%) (I2 = 93.5%, P < 0.001).

The results of this systematic review and meta-analysis show that the most common AEs following botulinum toxin injection for migraine headache prophylaxis are neck pain, followed by musculoskeletal weakness and injection site pain.

Context: 

Combat-related injuries remain prevalent on the battlefield despite advances in personal protective armor. Infections following these injuries pose a significant concern.

Evidence Acquisition: 

We used a combination of keywords, including ”combat” OR ”military”, ”wound” OR ”injury”, ”infection,” and ”prevention”, to identify relevant articles from major databases, including PubMed/MEDLINE,Web of Science, and Scopus.

Infection risk correlates with the extent and location of the injury. Severe open fractures and penetrating abdominal injuries carry a higher risk of infection than abrasions, blunt traumas, burns, or closed injuries, which are often infection-free. Combat-related infections can manifest early or late, with late-onset infections having a greater likelihood of multidrug resistance. Penetrating abdominal injuries are particularly susceptible to infection due to rapid bacterial colonization in the wounded area and the potential presence of drug-resistant gut microbiota pathogens. Aggressive surgical debridement, along with thorough irrigation and appropriate dressing, proves effective in infection prevention. The timely administration of prophylactic antibiotics is of utmost importance, with continued antibiotic prophylaxis in cases of delayed evacuation.

This review provides a concise summary of current literature on combat-related injury management, emphasizing infection prevention and control strategies.

Context: 

Calcium channel blockers (CCBs) play a crucial role in the treatment of cardiovascular diseases. Mebudipine, a dihydropyridine derivative CCB, was first synthesized in 1997. This study explores the potential benefits of mebudipine in managing cardiovascular disease, particularly as a derivative of nifedipine.

Evidence Acquisition: 

The article succinctly presents the advancements in mebudipine research, which were uncovered through extensive searches in reputable scientific databases such as ScienceDirect, Google Scholar, Scopus, and PubMed, conducted by 2 blinded researchers. The search focused on studies relevant to mebudipine, using specific keywords.

Mebudipine exhibits cardioprotective effects, reducing the occurrence of arrhythmias and minimizing heart tissue damage. Additionally, it has been found to enhance the levels of nitric oxide metabolites. Due to its limited solubility in water, mebudipine is typically administered using a nanoemulsion. Importantly, it has been deemed a safe drug without mutagenic effects.

Our review study underscores that mebudipine not only has a cardioprotective effect but also offers protection to other organs against various forms of injury induction. The mechanisms responsible for these protective effects may be linked to its ability to counteract oxidative stress, prevent apoptosis, and mitigate inflammation. Nevertheless, further research is needed to fully elucidate its potential.

Post-dural puncture headache (PDPH) is a common side effect after spinal anesthesia.

This study aimed to compare the sedative dose of propofol and midazolam in reducing headaches after spinal anesthesia.

In order to conduct this study, 80 candidates for spinal anesthesia were divided into two groups, A and B. Both groups received spinal anesthesia with marcaine. In group A, propofol was infused slowly at a dose of 30 g per minute, and in group B, 1 mg midazolam was injected intravenously. In the two groups, the incidence and intensity of headaches were measured using the VAS pain scale. Data were analyzed using Mann-Whitney and t-tests at a significance level of 0.05.

In this study, 65% (52) were male and 35% (28) were female. There was no significant difference between the two groups in terms of demographic information (P > 0.05). In the propofol group, the incidence and severity of headaches were significantly lower than in the midazolam group (P < 0.01).

This study’s results indicated that administering low-dose propofol as a sedative during spinal anesthesia may be more effective in reducing PDPH than midazolam.

Poor quality of life (QOL) can affect sleep quality in seniors due to its wide impact on the daily functioning of individuals. The place of residence is also considered one of the important factors in the physical and mental health of seniors.

This study aimed to determine the relationship between QOL and sleep quality in resident and nonresident seniors in Shahroud City.

This descriptive-analytical study was performedon232 nonresident and 78 resident seniors in Shahroud City, Iran, in 2019. The participants were selected using the convenience sampling method. Data collection tools included a demographic survey, the Pittsburgh Sleep Quality Index (PSQI), and the 36-Item Short-Form Health Survey (SF-36). After data collection, data analysis was performed using ANOVA, Pearson correlation, and independent t-test in SPSS version 19.

There was a significant relationship between QOL (dimensions and total score) and all sleep quality dimensions (P < 0.05) except for sleep efficiency (P = 0.214) and sleep disorder with mental dimension of QOL (P = 0.092). There was no significant difference in sleep quality between resident and nonresident seniors except for the variables of sleep duration and use of sleeping pills (P = 0.34). There was also a significant difference in the QOL of the seniors in terms of age (P < 0.001), sex (P = 0.021), marital status (P < 0.001), lifestyle (P < 0.001), education (P < 0.001), and income adequacy (P = 0.023).

Considering the strong relationship between QOL and sleep quality, implementing interventions (such as proper nutrition education, hot showers, etc.) aimed at improving sleep quality can positively affect QOL. It is also suggested to consider individual effective factors (such as more family support) to improve QOL.

Sleep quality is one of the factors affecting the health and performance of students. The current study aimed to compare sleep quality between active and inactive students during the COVID-19 pandemic in Iran.

In a cross-sectional study, 386 students (182 females; 144 males) studying in the Persian Gulf University voluntarily participated for 2 months in 2020. We used the Petersburg Sleep Questionnaire (electronically through university emails) to collect data.

Female students scored lower than male students in sleep duration (P = 0.002). Physically active students scored lower than physically inactive students in sleep quality (P = 0.003), sleep disturbances (P = 0.015), and daytime dysfunction (P = 0.005). Physically active female students obtained significantly lower scores in sleep quality (P = 0.002) and daytime dysfunction (P = 0.003) than physically inactive female students. Also, physically active male students obtained significantly lower scores than inactive male students on the subscales of sleep disturbances (P = 0.005) and the use of sleeping medication (P = 0.021).

Physical activity can play an important role in improving the sleep quality of students, and it should be emphasized during the restrictions imposed by epidemics.

The Burden of Disease study provides a comprehensive picture of mortality and disability across countries, time periods, age groups, and genders.

This study was conducted to determine the epidemiological trend and estimate the burden of COVID-19 in the Iranian population.

This cross-sectional study used the methods by theWorld Health Organization for the national burden of disease studies to estimate the years of life lost due to premature death and burden of disability (YLD), years of life lost from mortality (YLL), years of life lost due to disability diseases, and the total burden of death and disability in terms of disability-adjusted life years (DALY). The information to calculate the desired indicators for COVID-19 in Iranian population, including the number of deaths, the number of hospitalizations, and the costs of hospitalization and treatment of patients, was obtained from an insurance fund of the Islamic Republic of Iran. Excel software version 2017 is used to calculate 3 indicators.

The total DALY for COVID-19 in the Iranian population during the three-year study period was calculated to be 162,429 years, which is a significant figure. The disease burden showed an increasing trend in the study years and reached its peak in 2021, which aligns with the overall disease situation in the country. In general, the burden of disease was higher in men than in women.

The impact of COVID-19 on the population and its economic burden was substantial in the studied areas. Therefore, it is crucial to undertake careful planning in addressing these issues. Using economic burden studiesand examining their dimensions provides policymakers with sufficient evidence to allocate financial resources to vital sectors and adopt appropriate policies in critical situations.