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Background: Since 1990, the maternal mortality significantly decreased at global scale as well as the North Africa and Middle East. However, estimates for mortality and morbidity by cause and age at national scale in this region are not available. Method(s): This study is part of the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019. Here we report maternal mortality and morbidity by age and cause across 21 countries in the region from 1990 to 2019. Result(s): Between 1990 and 2019, maternal mortality ratio (MMR) dropped from 148.8 (129.6-171.2) to 94.3 (73.4-121.1) per 100 000 live births in North Africa and Middle East. In 1990, MMR ranged from 6.0 (5.3-6.8) in Kuwait to 502.9 (375.2-655.3) per 100 000 live births in Afghanistan. Respective figures for 2019 were 5.1 (4.0-6.4) in Kuwait to 269.9 (195.8-368.6) in Afghanistan. Percentages of deaths under 25 years was 26.0% in 1990 and 23.8% in 2019. Maternal hemorrhage, indirect maternal deaths, and other maternal disorders rank 1st to 3rd in the entire region. Ultimately, there was an evident decrease in MMR along with increase in socio-demographic index from 1990 to 2019 in all countries in the region and an evident convergence across nations. Conclusion(s): MMR has significantly declined in the region since 1990 and only five countries (Afghanistan, Sudan, Yemen, Morocco, and Algeria) out of 21 nations didn't achieve the Sustainable Development Goal (SDG) target of 70 deaths per 100 000 live births in 2019. Despite the convergence in trends, there are still disparities across countries.Copyright © 2022 Academy of Medical Sciences of I.R. Iran. All rights reserved.
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Background: Occupational exposure to blood and body secretions poses a significant risk of COVID-19, HIV, HCV, and HBV among healthcare workers (HCWs). Assessment of this exposure is necessary for optimized planning and policy-making measures. This study aimed to assess the exposure to occupational risk factors among emergency HCWs.
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This paper presents a novel mathematical model to simultaneously tackle the economic dispatch (ED) problem considering valve point effect, load uncertainty, distributed generation (DG) uncertainty, incentive-based demand response, and plug-in electric vehicle into the transmission expansion planning (TEP) problem to minimize the total cost of the system. Monte-Carlo is employed to consider the uncertain characteristic of DGs and loads. Considering ED problem in solving TEP problem with uncertain aspects of DGs and loads, made the problem so complicated. So, to overcome this complicity, a new meta-heuristic coronavirus herd immunity optimizer (CHIO) algorithm is utilized. The presented methodology is verified on an IEEE 24-bus test system. Finally, to evaluate the CHIO algorithm efficiency, a comparison is made between the results obtained by CHIO and Branch and Bound (B&B) algorithm. Numerical results show the efficiency of the newly presented methodology in solving TEP and ED problems simultaneously.
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Aim: Despite concerns about cardiovascular implications in coronavirus disease-2019 (COVID-19) patients, not all COVID-19 patients are visited by cardiologists and recommended to perform comprehensive cardiovascular assessments including measurement of biomarkers and echocardiography. We aimed to investigate the reasons for seeking cardiology care and to assess our cardiologists' diagnostic approaches to COVID-19 patients with potential cardiovascular involvement. Methods and Results: In this prospective, observational study, data of all consecutive COVID-19 patients admitted to six designated hospitals for COVID-19 in Iran in whom bedside cardiology consultation was requested were collected. A total of 148 patients including 105 (71%) males were included. The mean age was 57 ± 17 years. The most common reasons for cardiology consultation were dyspnea (56.7%), chest pain (12.8%), and suspected arrhythmias (10.8%). The most common comorbidities were hypertension (40.5%), diabetes mellitus (19.6%), and coronary heart disease (18.9%). A 12-lead electrocardiography (ECG) was obtained in all patients. Point-of-care ultrasonography or limited transthoracic echocardiography (TTE) was performed in 106 (71.6%) patients, and complete TTE was performed in 35 (23.4%) patients. Cardiac troponin was measured in 63 (42.6%) patients, and N-terminal pro B-type natriuretic peptide level was measured in 34 (23%) patients. Overall, 51 (34.5%) patients underwent invasive mechanical ventilation, inotropes were used in 29 (19.6%) patients, and 40 (27%) patients died. Conclusions: While preventing unnecessary investigations, the cardiologists should not overlook the lifesaving role of ubiquitous diagnostic modalities (such as ECG and TTE) in early detection and management of cardiac involvement in COVID-19.
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Background: In recent months, coronavirus disease 2019 (COVID-19) has been a global health challenge. Nutrition is a determining factor for health. Objectives: In the present research, we assessed and compared dietary food groups and nutrient supplements intake of diabetic, hypertensive, and heart disease patients with clinical symptoms of COVID-19 and asymptomatic controls. Methods: This retrospective case-control research was conducted on 98 patients with diabetes, hypertension, and/or heart disease, of whom 37 cases were COVID-19 positive with clinical symptoms. Dietary intakes of participants were recorded using a Food Frequency Questionnaire (FFQ), which was designed and validated for the Iranian population. Results: We found that 54% of all subjects had consumed nutritional supplements in the last six months, and there was no significant difference in the type of nutritional supplements between cases and controls. There was no significant difference in the median intake of food groups in the last year in patients with metabolic syndrome and clinical symptoms of COVID-19 compared to controls. The CRUD odds ratio (OR) showed that adequate consumption of any food group was not associated with the occurrence of COVID-19. Conclusions: Although dietary intake and nutritional supplements are effective in preventing clinical symptoms of COVID-19, up to now, adequate data are available for recommending these supplements above the Recommended Dietary Allowances (RDA) for the prevention and/or treatment of COVID-19.
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Introduction: Organ transplant recipients might be more likely to develop COVID-19, as they receive long-term immunosuppressives and have comorbidities. Case Presentation: Herein, we reported the case of a 32-year-old man with unilateral lung transplantation due to unclassifiable lung fibrosis on pathologic evaluation who presented with cough, fever, and headache. After evaluation with RT-PCR test and chest CT scan, COVID-19 in the previously transplanted lung was diagnosed. However, the other non-transplanted fibrotic lung was not involved. Conclusions: Lack of COVID-19 involvement in the fibrotic lung tissue in our case without any other risk factors might be related to the fact that the lung with underlying diseases was less susceptible to COVID-19 as unhealthy lungs have lower ACE2 receptors, or it might be related to genetic differences between the donor and recipient.
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Objectives: COVID-19, a novel Coronavirus from same family as SARS-CoV-2 is a highly contagious virus. It is transmitted mainly from upper respiratory system and affects important organs, like heart and lungs. The aim of this study is identifying appropriate therapeutic methods originated from persian medicine. Materials and Methods: This study has been designed from the viewpoints of traditional and modern medicine. Considering modern medicine, we searched valid database by searching key words “SARS-Cov-2” and “COVID-19”. For traditional medicine, we searched reliable traditional medicine like the “Canon of Medicine” by “Avicenna”, the Exir-e Aazam and Zakhira-I Kharazm Shahi. Patients were evaluated according to their symptoms and categorized based on traditional medicine. Physiopathology and management of the disease, including prevention and treatment were studied. Results: The principle underlying mechanism seems to be warm and dry dystemperament that affects different organs and causes various adverse effects which are higher than warm and dry dystemperament, but less than the presence of virus. Our traditional Iranian medicine findings are validated by the modern medicine. Conclusion: Based on symptoms, the equivalent of this disease was examined from the viewpoint of traditional medicine. Then, physiopathology and management of this disease were presented in five levels, including one stage of prevention and four stages of treatment, and finally, the treatment recommendations of Iranian traditional medicine were approved with new research results.
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In recent months, the greatest health challenge worldwide has been the outbreak of the novel coronavirus, COVID-19. During pregnancy, women are especially vulnerable perhaps in part because of fluctuations in levels of hormones that are involved in the immune response, and therefore, they need to take special preventive measures. In addition to measures to avoid the spread of the virus, such as handwashing, masks, and social distancing, it is important to ensure that food intakes are healthy, adequate, and high in both nutritional quality and food safety. Supportive nutrition through the provision of food baskets adequate in energy, protein, calcium, iron, folic acid, choline, omega-3 fatty acids, and vitamin D at levels sufficient for pregnancy is likely to be needed for many pregnant women in low-income families or families where spouses, jobs, and income have been lost because of COVID-19.
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Purpose: The coronavirus disease 2019 (COVID-19) is an infectious disease that puts strain on health-care systems. Obesity is considered as a risk factor for the severity of infection. Hypotheses also suggested some nutritional supplements may be useful in COVID-19. This paper aims to assess the role of body mass index (BMI) and nutritional supplements on the severity of COVID-19. Design/methodology/approach: This research was conducted on 603 participants (in five groups including: exposure to virus and healthy, COVID-19 positive patients with severity of mild, moderate, severe and death from COVID-19), in age 18 to 65 years. Demographic data and history of nutritional supplements were asked. Anthropometric measurements were measured in a healthy group and in a patient. They were collected by referring to patients' medical records. Findings: The mean of BMI in groups with severity symptoms of moderate (27.57 kg/m2), severe (29.70 kg/m2) and death persons (28.13 kg/m2), was significantly higher than healthy (26.70 kg/m2) and mild symptoms (26.57 kg/m2) groups (p = 0.001). The logistic regression shown, the fourth quartile of BMI was significantly associated with occurrence of COVID19, odds ratios (ORs) and 95% confidence intervals (CI): [OR: 1.81, (95% CI: 1.13– 2.89), p-for trend = 0.55]. There was no significant difference in the percentage of vitamin C, D3, Zinc, Iron and multivitamin supplements intake, between groups, in the past six months (p = 0.11). Originality/value: This study indicated the role of higher BMI in the occurrence and severity of COVID-19. Researches are not enough to recommend consumption of nutritional supplements for the prevention of COVID-19. © 2020, Emerald Publishing Limited.
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COVID-19 is an ongoing pandemic that is not known well. According to our current knowledge, although respiratory manifestations are the most common symptoms of COVID-19, but non-pulmonary manifestations are also commonly reported, such as rashes, ap-pendicitis, volvulus, diverticulitis, and mesenteric lymphadenitis. In this case series, we introduced four children with COVID-19 who presented with gastrointestinal symptoms.
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Following the detection of the first case of infection due to COVID-19 in Iran central province (named Markazi) on 18 Feb 2020, a serious alert was announced at Arak University of Medical Sciences (the main medical university in Markazi province) to prevent a disaster. The performed measures played a unique role in improving patient care and prevention and control of the disease. Previously, it was expected that Markazi province, due to being situated on the junction of the national highways and placing in the center of Iran, was faced with huge health and social crisis. However, fortunately, the disease morbidity and mortality have been placed in a stabilized status after 7 weeks of the epidemic.