The Added-on of Ziziphus jujube Syrup in the Treatment of Chronic Spontaneous Urticaria Resistant to Standard-Dose of Secondary-generation H1 Antihistamine: A Double-Blind Randomized Clinical Trial.

Background: Although antihistamines are the first-line treatment for chronic spontaneous urticaria (CSU), 50% of patients don't respond to standard doses. In this study, the effectiveness of Ziziphus jujube fruit syrup in combination with antihistamines was assessed in patients with CSU. Methods: This double-blind randomized clinical trial was conducted in Shiraz between December 2019 and December 2020. 64 patients with CSU who had experienced hives for at least six weeks and did not respond to the usual treatments were enrolled in the study. They were randomly assigned to intervention and control groups using permuted block random allocation. For four weeks, the intervention group received 7.5 mL Ziziphus jujube syrup twice a day, while the control group received 7.5 mL simple jujube syrup twice a day. Both groups received cetirizine 10 mg every night. Urticaria activity score (UAS) and CU-Q2oL questionnaires were used to assess urticaria state and sleep quality before and after each week for four consecutive weeks. Data were analyzed using SPSS software version 18, and P<0.05 was considered statistically significant. Results: Before the intervention, there was no statistically significant difference between the two groups' mean of UAS (P=0.490) and sleep quality (P=0.423). During the follow-up, UAS in the intervention group was significantly lower (P=0.001). Moreover, this difference was significant on the day 28 (P=0.046). During the follow-up, the quality of sleep in both groups improved significantly, and this improvement was more significant in the intervention group. Conclusion: Ziziphus jujube syrup could be an effective adjuvant treatment for CSU.Trial Registration Number: IRCT20190304042916N1.

The role of comorbidities on mortality of COVID-19 in patients with diabetes.

BACKGROUND: Patients with diabetes are one of the most high-risk group to become infected with SARS-CoV-2. Current study was designed to evaluate the risk of other complications in COVID-19 patients with diabetes. METHODS: In this cross-sectional study (25 February to July 10, 2020), 458 patients with diabetes were enrolled based on their characteristics, symptoms and signs, laboratory data and presence of other underlying diseases. Multiple logistic regression and Chi-square test analysis were used to check the effectiveness of other comorbidities on the mortality outcome among patients with diabetes. RESULTS: Of 458 patients with diabetes, 306 (67%) had other underlying diseases, such as 200 (65.4%) hypertension, 103 (33.7%) cardiovascular diseases and 29 (9.5%) kidney diseases. The rate of fatality was significantly high in patients with chronic kidney and liver diseases. The odds of mortality were increased 3.1-fold for patients over 55 years as compared to those under 55 years (P = 0.011), and the odds of mortality outcome were more than 5.1-fold for those who had chronic kidney disease (P < 0.001). CONCLUSIONS: The presentation of SARS-CoV-2 in older patients with diabetes with other comorbidities such as chronic kidney and liver diseases is more severe in risk of mortality.

Does Determination of Initial Cluster Centroids Improve the Performance of K-Means Clustering Algorithm? Comparison of Three Hybrid Methods by Genetic Algorithm, Minimum Spanning Tree, and Hierarchical Clustering in an Applied Study.

Random selection of initial centroids (centers) for clusters is a fundamental defect in K-means clustering algorithm as the algorithm's performance depends on initial centroids and may end up in local optimizations. Various hybrid methods have been introduced to resolve this defect in K-means clustering algorithm. As regards, there are no comparative studies comparing these methods in various aspects, the present paper compared three hybrid methods with K-means clustering algorithm using concepts of genetic algorithm, minimum spanning tree, and hierarchical clustering method. Although these three hybrid methods have received more attention in previous researches, fewer studies have compared their results. Hence, seven quantitative datasets with different characteristics in terms of sample size, number of features, and number of different classes are utilized in present study. Eleven indices of external and internal evaluating index were also considered for comparing the methods. Data indicated that the hybrid methods resulted in higher convergence rate in obtaining the final solution than the ordinary K-means method. Furthermore, the hybrid method with hierarchical clustering algorithm converges to the optimal solution with less iteration than the other two hybrid methods. However, hybrid methods with minimal spanning trees and genetic algorithms may not always or often be more effective than the ordinary K-means method. Therefore, despite the computational complexity, these three hybrid methods have not led to much improvement in the K-means method. However, a simulation study is required to compare the methods and complete the conclusion.

The Correlation between Using Social Networks and the General Health of Multiple Sclerosis Patients.

BACKGROUND: Multiple sclerosis (MS) threatens the patients' independency and ability to effectively participate in the society. The aim of this study was to determine the correlation between using social networks on the general health of multiple sclerosis patients. METHODS: This study was performed on 80 MS patients referring to Shiraz University of Medical Sciences, Chamran, and Imam Reza Hospital in 2017, whose condition had improved and were treated by a specialist physician. Tools for data collection were general health questionnaire (GHQ-28) and social networks use questionnaires. RESULTS: Amongst the 80 individuals with MS, 65 (81.3%) were female and 15 (18.8%) were male. Our results suggest that patients with higher levels of education had higher levels of health (P = 0.01). Telegram and WhatsApp, respectively, had a positive correlation with general health (P = 0.007, P = 0.007), anxiety (P = 0.003, P = 0.028), and social dysfunction (P = 0.007, P = 0.007). WhatsApp with 33.64% was the most popular application among MS patients. The correlation between general health and duration of using social networks was not statistically significant (r = 0.22, P = 0.06). Also, no significant correlation was found between the duration of using social networks and the general health (P = 0.62). CONCLUSION: Our findings suggest that social networks, especially Telegram and WhatsApp, had a positive correlation with general health, anxiety, and social dysfunction of patients. Therefore, the use of social networks can be considered as a suitable option in reducing the aforementioned concerns among patients with MS. On the other hand, general health and mood status might as well influence the use of social network in MS patients.