ABSTRACT
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.
ABSTRACT
Objective(s): The outbreak of Covid-19 is a global health emergency. Compliance with health protocols is the main key to preventing the transmission of this disease. The purpose of the present study was to review the related research to investigate the factors affecting compliance with health protocols related to Covid-19. Methods: This scoping review examined studies published in Persian and English language biomedical journals with related keywords including health protocols, masking, quarantine, distancing, hand washing, and risk perception in search engines such as Google Scholar, PubMed, Web of Science, and SID. Results: In all 22 relevant articles were entered into the review. The results led to the identification of more than 30 effective factors in compliance with health protocols. Factors such as gender, understanding the risk of disease, government measures, the role of friends and family, the media, and people's information sources played the biggest role in people's compliance with the protocols, respectively. Also, protective measures such as staying at home when feeling unwell, covering coughs and sneezes, and not using public transportation during the COVID-19 pandemic had reported having the highest compliance rate and the lowest was behaviors such as washing hands after sneezing and coughing as well as disinfecting the mobile phone. Conclusion: To increase compliance with protocols, it is necessary to consider individual and environmental factors affecting compliance with protocols, which can be categorized as facilitators, barriers, and encouragers of target health behaviors as these factors are context and time-dependent. Timely identification of accurate factors in any country is a key step in formulating and designing interventions to manage pandemics such as Covid- 19. © Iranian Institute for Health Sciences Research. All rights reserved.
ABSTRACT
Guillain-Barre syndrome (GBS), the most frequent cause of acute paralytic neuropathy, is an inflammatory polyneuropathy that is autoimmune in nature. Many infectious agents such as Campylobacter jejuni (the most commonly identified bacteria associated with GBS), cytomegalovirus, Epstein-Barr virus, measles virus, influenza A virus, and Mycoplasma pneumonia, as well as enterovirus D68 and Zika virus and noninfectious agents such as vaccines and surgeries have been reported to trigger GBS. Three main variants of GBS include the classic acute inflammatory demyelinating polyneuropathy (AIDP), which is the most common presentation of GBS, Miller Fisher syndrome, and the recently defined axon loss variants (acute motor axonal neuropathy and acute motor and sensory axonal neuropathy). One of the assumptions about the mechanisms of GBS is molecular mimicry, which is a process caused due to the structural resemblance between a microorganism and the host. The original concept of GBS is rooted in molecular mimicry defined as the similarity between the microorganisms' peptide sequences or epitopes and ganglioside sequences or structures. Since the coronavirus disease-2019 outbreak in January 2020 there have been cases of GBS reported. Our review aims at providing an overview of some case reports of the severe acute respiratory syndrome coronavirus-2-related GBS. Copyright (C) 2021 Wolters Kluwer Health, Inc. All rights reserved.