Epidemiology of measles in southern Iran: trends, challenges, and vaccination insights.

Background: Measles, a highly contagious and vaccine-preventable disease, continues to present global public health challenges. This retrospective study focused on measles outbreaks in Hormozgan province, southern Iran, spanning from 2014 to 2019. Methods: Between 2014 and 2019, patients suspected of having measles, as reported by medical centers in Hormozgan, were subject to a comprehensive evaluation. The diagnosis of measles was conclusively established through the use of real-time polymerase chain reaction (RT-PCR) testing. A detailed collection of pertinent data was undertaken. SPSS software, version 21, was employed for statistical analysis. Results: In the current study, out of 1291 clinically suspected measles cases, 151 were PCR-confirmed, with an average age of 16.77 years (±10.46), comprising 50.9% males and 49.1% females. The annual distribution showed varied incidence: 8.4% in 2014, peaking at 18.8% in 2015, then fluctuating to 11.4% in 2016, 0.8% in 2017, and 17.9% in 2018, with no cases in 2019. Among confirmed cases, 16.5% were vaccinated, while 68.2% were not, and 15.23% had unknown vaccination status. Conclusion: This retrospective study highlights the ongoing challenge of measles in Hormozgan province, Iran, from 2014 to 2019. Despite measles being preventable by vaccination, a significant number of cases were confirmed among both vaccinated and unvaccinated individuals, indicating gaps in immunization coverage and effectiveness. The fluctuating annual incidence, with a peak in 2015 and no cases in 2019, suggests variable success in disease control efforts. This underscores the need for enhanced surveillance, improved vaccination strategies, and public health interventions to effectively combat measles outbreaks in this region.

Relationship between self-efficacy and adherence to antiretroviral therapy in HIV/AIDS patients: An analytical cross-sectional study in southern Iran.

Background and Aims: The human immunodeficiency virus (HIV) infection, also known as acquired immunodeficiency syndrome (AIDS), is spreading rapidly in the world, especially in developing countries, and is considered a serious health threat. This study aimed to assess the relationship of adherence antiretroviral therapy (ART) and self-efficacy among people living with HIV. Methods: This cross-sectional study was conducted in March-July 2022 at the Center for Behavioral Diseases in Bandar Abbas. A total number of 208 HIV patients treated with ART entered the study after voluntarily signing an informed letter of consent. The data collection instrument was the adherence to ART questionnaire with the six subscales and the General Self-Efficacy Scale-17 (GSE-17) general self-efficacy questionnaire. Multivariate regression analysis was used to test the relationship among the variables. Results: The participants' mean age was 41.7 ± 8.2 years. Self-efficacy was positively correlated with adherence ART. With every one score of increased self-efficacy, MA increased for 0.85 score (p < 0.001) and medical challenges have the strongest correlation (r = 0.27) with self-efficacy. The multivariable regression analysis showed that moderate and high socioeconomic status (SES) each improved MA for 18 and 22 units, respectively, compared to poor SES. Alcohol consumption reduced MA for 11 units. Conclusion: This study proved the positive relationship of self-efficacy in adherence to ART in HIV patients. The insights offered by this research can help develop a systematic and effective intervention to promote MA in HIV patients. SES and alcohol consumption significantly affect MA.

Bell's palsy: a case report of unusual presentation in a patient with rhino-orbital cerebral mucormycosis.

BACKGROUND: Mucormycosis is a fungal infection caused by the Mucorales order of fungi. This fungus is commonly found in soil and can cause disease in immunocompromised patients. On the other hand, Bell's palsy is an idiopathic condition that results in the sudden onset of unilateral facial muscle weakness, affecting the facial nerve. CASE PRESENTATION: A 51-year-old Persian housewife with a history of poorly controlled diabetes mellitus presented with a splitting headache that had been ongoing for 1 week and an inability to close her left eye or make facial expressions on the left side of her face. The patient's vital signs were normal, but physical examination revealed a yellow-grey scar on the left side of her hard palate and Bell's palsy on the left side. A neurological examination showed that she could move both eyes but could not close her left eye, move up her left eyebrow, or smile. Further investigations were performed, including laboratory tests, radiologic imaging, and functional endoscopic sinus surgery. The patient underwent three rounds of debridement for bony erosion in the medial and posterior walls of the left maxillary sinus and the hard palate. Pathological examination confirmed mucormycosis infection in the hard palate and mucosa. CONCLUSION: Fungal infection must be considered a potential diagnosis for immunocompromised adults who exhibit symptoms of Bell's palsy.

Investigation the longevity of hepatitis B surface antibody in vaccinated students of Hormozgan university of medical sciences.

Background and Objectives: Hepatitis B is a common chronic viral infection in humans. Universal use of hepatitis B vaccine is crucial for controlling the infection, but the duration of vaccine-induced immunity remains uncertain. This study aimed to assess hepatitis B antibody levels (anti-HBs) after vaccination in infancy and adolescence, and explore the relationship between immunity levels and variables such as age, sex, BMI, place of birth, and duration since last vaccination among students at Hormozgan University of Medical Sciences from 2019 to 2021. Materials and Methods: The study included 1134 students who completed a questionnaire and provided blood samples for ELISA-based measurement of antibody titers. Results: The findings revealed that 727 students (64.1%) had no protective antibody level (anti-HBs <10 mIU/ml), 299 (26.4%) had partial immunity (anti-HBs 10-100 mIU/ml), and 108 (9.5%) had complete immunity (anti-HBs >100 mIU/ml). No statistically significant relationships were observed between anti-HBs titer and age, sex, or BMI. However, antibody titer decreased with increasing time since last vaccination (P<0.001). Conclusion: This study highlights the decline in antibody titer over time following primary vaccination. Sustained immunity against hepatitis B virus relies on antibody durability or robust immunological memory, suggesting the importance of timing booster vaccinations.

Predicting the COVID-19 vaccine receive intention based on the theory of reasoned action in the south of Iran.

BACKGROUND: Vaccination against Covid 19 disease was based on rational practice theory. One of the most effective methods to control the COVID-19 pandemic is extensive vaccination coverage in the shortest time. The relevant beliefs and predictors of COVID-19 vaccine and the barriers to and facilitators of receiving COVID-19 vaccine should be identified. Individuals' intention to receive COVID-19 and the effective factors are of an utmost importance. This study aimed to predict intention to receive COVID-19 vaccine in the South of Iran. METHODS: This cross-sectional study was performed over a period of 2 months (May 2021 to July 2021) in 4 southern provinces in Iran. The study population of this study included people over 18 years of age who did not receive the COVID-19 vaccine. The online questionnaire was used to collect data. We recruited participants through a self-selection sampling method and posted the online survey link. The questionnaire had two parts: demographic information and Theory of Reasoned Action (TRA) questions. All statistical calculations and hypotheses tests were performed using SPSS21 and Amos21 software and the significance level was considered 0.05. RESULTS: A total number of 2556 people participated in this study with a mean age of 37.76 (10.7) of years (Age Range = 18-75). The findings showed that attitudes and subjective norms and the use of social media predict the intention to receive COVID-19 vaccine. SEM showed that attitude (ß = 0.596, P < 0.001), subjective norms (ß = 0.265, P < 0.001) were significant predictors of vaccination intention. In this study, 78% of people were willing to receive the vaccine when they were officially allowed to. CONCLUSION: According to the results of the study, it is suggested to strengthen positive attitudes and subjective norms about the importance of COVID-19 vaccination as well as using social media to inform the community in order increase the intention to vaccinate COVID-19 and increase vaccine coverage.

Knowledge, attitude, and preventive behaviors of Hormozgan residents toward COVID-19, one month after the epidemic in Iran.

Aim: COVID-19 has become prevalent in the world since December 2019. The further prevalence of the disease can be prevented by correct management of society and increasing knowledge, practices, and attitudes of the people. The present research aimed to evaluate the knowledge, attitudes, and preventive behaviors of people in Hormozgan in the south of Iran toward COVID-19. Subject and methods: The present cross-sectional research was conducted over 2 months (March 2020-April 2020). The online questionnaire comprised four sections: demographic information, knowledge, attitude, and behavior toward COVID-19. Knowledge included 36 items, attitude eight items, and behavior ten items. The collected data were analyzed statistically using SPSS ver. 22. The split-half method was used to test the reliability of knowledge and the estimated value was 0.84. That of attitude and behavior was estimated via Cronbach's alpha and was found to be 0.81 and 0.75, respectively. Results: A total number of 2024 participants with an average age of 33.94 years took part in this research. Of all participants, 64.4% were female. According to the results, 65.8% enjoyed a good level of knowledge and 34.2% enjoyed an average level. In addition, 63.2% demonstrated a good attitude and 36.8% an average level. A large percentage of participants (90.6%) had good practices and only 9.4% had an average level of practices. Conclusion: The present findings show that participants had a relatively good level of knowledge, positive attitude, and good behavior concerning COVID-19.

Interplay between SARS-CoV-2-derived miRNAs, immune system, vitamin D pathway and respiratory system.

The new coronavirus pandemic started in China in 2019. The intensity of the disease can range from mild to severe, leading to death in many cases. Despite extensive research in this area, the exact molecular nature of virus is not fully recognized; however, according to pieces of evidence, one of the mechanisms of virus pathogenesis is through the function of viral miRNAs. So, we hypothesized that SARS-CoV-2 pathogenesis may be due to targeting important genes in the host with its miRNAs, which involved in the respiratory system, immune pathways and vitamin D pathways, thus possibly contributing to disease progression and virus survival. Potential miRNA precursors and mature miRNA were predicted and confirmed based on the virus genome. The next step was to predict and identify their target genes and perform functional enrichment analysis to recognize the biological processes connected with these genes in the three pathways mentioned above through several comprehensive databases. Finally, cis-acting regulatory elements in 5' regulatory regions were analysed, and the analysis of available RNAseq data determined the expression level of genes. We revealed that thirty-nine mature miRNAs could theoretically derive from the SARS-CoV-2 genome. Functional enrichment analysis elucidated three highlighted pathways involved in SARS-CoV-2 pathogenesis: vitamin D, immune system and respiratory system. Our finding highlighted genes' involvement in three crucial molecular pathways and may help develop new therapeutic targets related to SARS-CoV-2.

Application of the protection motivation theory for predicting COVID-19 preventive behaviors in Hormozgan, Iran: a cross-sectional study.

BACKGROUND: The high prevalence and mortality of coronavirus disease 2019 (COVID-19) have made it the most important health and social challenge around the world. However, this disease can be largely prevented by adherence to hygienic principles and protective behaviors. It seems that identifying the processes involved in protective health behaviors can be effective in planning and implementing suitable interventions to encourage the community toward protective behaviors. Therefore, the present study aimed to predict the preventive behaviors of COVID-19 according to the Protection Motivation Theory (PMT). METHODS: This cross-sectional study was conducted over 2 months in Hormozgan Province, Iran. The study population consisted of all citizens above the age of 15 years. An online questionnaire was used to collect the data. The questionnaire link was available to the participants through social networks. The questionnaire consisted of two sections, including the demographic information and the PMT constructs. All statistical calculations and hypothesis testing were performed in SPSS Version 21 and AMOS Version 21. The significance level was considered to be 0.05 for hypothesis testing. RESULTS: A total of 2032 subjects, with the mean age of 34.84 ± 9.8 years (r = 15-98), participated in this study. Most of the participants were 31-40 years old, female (60.4%), married (72%), urban residents (87.3%), and employed (58.8%). The majority of them also had a bachelor's degree or higher (58.8%). Significant positive correlations were observed between the preventive behaviors of COVID-19 and the perceived vulnerability (r = 0.192, P < 0.001), perceived severity (r = 0.092, P < 0.001), response efficacy (r = 0.398, P < 0.001), self-efficacy (r = 0.497, P < 0.001), and protection motivation (r = 0.595, P < 0.001). On the other hand, significant negative correlations were found between the preventive behaviors of COVID-19 and maladaptive behavior rewards (r = - 0.243, P < 0.001) and perceived costs (r = - 0.121, P < 0.001). CONCLUSION: The present findings showed that maladaptive behavior reward and fear negatively predicted the protective behaviors. On the other hand, response efficacy and self-efficacy positively predicted the protective behaviors; the impact of self-efficacy was the strongest. Overall, the information provided in this study can contribute to health policymaking in Iran.

The Influence of Indoor Environmental Factors on the Prevalence of House Dust Mites as Aeroallergens in Bandar Abbas Student Dormitories, South of Iran, 2019.

This study was conducted to determine the influence of environmental factors on the prevalence of house dust mites in student dormitories of Bandar Abbas city. In this study, 64 dust samples were collected from seven randomly selected dormitories located in various areas of the Bandar Abbas. The collected mites were isolated and mounted in Hoyer's medium and identified using a morphological key. The associations between the environmental factors and the density of house dust mites were investigated. In total, 1,093 adult mites were collected and identified. They consisted of four species including Dermatophagoides pteronyssinus Trouessart (57.6%), Dermatophagoides farinae Hughes (24.3%) and Dermatophagoides evansi Fain (14.9%) (Acari: Pyroglyphidae), and Cheyletus malaccensis Oudemans (3.2%) (Acari: Cheyletidae). All of the dormitories were contaminated by more than one house dust mites species and the mean density of house dust mites in dormitories was 8.3 ± 0.2 mites/g of dust. There was a significant relationship between average house dust mites density and some of environmental factors such as relative humidity, temperature, floor covering type, and number of occupants (P < 0.05). Results of this study revealed that two major allergenic dust mites, D. pteronyssinus and D. farinae, were the most prevalent and collected from all of dormitories and some of indoor environmental factors found to influence mites' population.

The Efficacy of Famotidine in improvement of outcomes in Hospitalized COVID-19 Patients: A structured summary of a study protocol for a randomised controlled trial.

OBJECTIVES: This study aims to investigate the effect of Famotidine on the recovery process of COVID-19 patients. TRIAL DESIGN: This phase III randomized clinical trial was designed with two parallel arms, placebo-controlled, single-blind, and concealed allocation. PARTICIPANTS: All COVID-19 patients admitted to Shahid Mohammadi Hospital in Bandar Abbas whose PCR test results are positive for SARS-Cov-2 and sign the written consent of the study are included in the study and immunocompromised patients, end-stage renal disease, moderate renal failure (clearance Creatinine 30 to 50 ml/min) or stage 4 severe chronic kidney disease or need for dialysis (creatinine clearance lesser than 30 ml/min), history of liver disease, hepatitis C infection or alcoholism, Glucose 6 phosphate dehydrogenase deficiency(G6PD), the ratio of Alanine transaminase to Aspartate transaminase 5 times above the normal limit, history or evidence of long QT segment on Electrocardiogram, psoriasis or porphyria, pregnancy, use of oral contraceptives, Dasatinib, Neratinib, Ozanimod, Pazopanib, Rilpivirine, Siponimod and/or Tizanidine and allergies to any study drug are excluded. INTERVENTION AND COMPARATOR: Intervention group receives standard pharmacotherapy according to the treatment protocols of the National Committee of COVID-19 and oral famotidine 160 mg (Manufactured by Chemidarou Pharmaceutical Company) four times a day until the day of discharge, for a maximum of fourteen days. Comparator group receives standard drug therapy according to the treatment protocols of the National Committee of COVID-19 and placebo in the same dosage. MAIN OUTCOMES: Patients' temperature, respiration rate, oxygen saturation, lung infiltration, lactate dehydrogenase and complete blood count were measured at the baseline (before the intervention) and on day 14 after the intervention or on the discharge day. RANDOMISATION: The person who has no role in admitting patients and assigning patients to random codes preparing random sequences using online tools and by permuted block randomization method. Eligibility criteria are monitored by the person responsible for admitting patients. Codes in a random sequence are assigned to patients by the treatment team without knowing that each code is in the intervention or comparator group. Patient codes are then matched to randomly generated sequence information for interventions. BLINDING (MASKING): All participants are unaware of which group of this study they are in and after grouping patients in the groups, Patients receive Famotidine in the treatment group and receive a placebo in the control group. The lead researcher, care givers, data collectors, and outcome assessors are aware of the grouping of patients. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): As there is no prior work on this research question, so no assumptions for the sample size calculation could be made. A total of 20 patients participate in this study, which are randomly divided into two groups of 10 as intervention or control groups. TRIAL STATUS: Version 3 of the protocol was approved by the Deputy of Research and Technology and the ethics committee of Hormozgan University of Medical Sciences on August 2, 2020, with the local code 990245, and the recruitment started on August 17, 2020. recruitment ended on August 31, 2020. Since the recruitment ended earlier than expected (the expected recruitment end date was 21/12/2020), we submitted post recruitment but prior to publication of the results. TRIAL REGISTRATION: The protocol was registered before starting subject recruitment under the title: The effect of Famotidine on the improvement of patients with COVID-19, IRCT20200509047364N2, at Iranian Registry of clinical trials ( https://www.irct.ir/trial/49657 ) on 17 August 2020. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).

Effects of Licorice on clinical symptoms and laboratory signs in moderately ill patients with pneumonia from COVID-19: A structured summary of a study protocol for a randomized controlled trial.

OBJECTIVES: We investigate the effects of Licorice (Glycyrrhiza glabra L.) root extract, an anti-inflammatory natural medicine, compared to the usual therapeutic regimen on clinical symptoms and laboratory signs in patients with confirmed COVID-19 that are moderately ill. TRIAL DESIGN: This is a single-center, open-label, randomized, clinical trial with parallel-group design. This study is being conducted at Shahid Mohammadi Hospital, Bandar Abbas, Iran. PARTICIPANTS: Both male and female patients with ≥18 years of age (≥ 35 kg of weight), admitted at the Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas for treatment, screened for the following criteria. INCLUSION CRITERIA: 1. Confirmed diagnosis of SARS-CoV-2 infection (via polymerase chain reaction [PCR] and/or antibody test). 2. Presenting as moderate COVID-19 pneumonia (via chest computed tomography (CT) and/or X-ray) requiring hospitalization. 3. Hospitalized ≤48 hours. 4. Signing informed consent and willingness of study participant to accept randomization to any assigned treatment arm. EXCLUSION CRITERIA: 1. Underlying diseases, including chronic heart disease, chronic hypertension, severe renal failure, severe liver failure, and thyroid disorders. 2. Severe and critical COVID-19 pneumonia. 3. Use of warfarin, selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), diuretics, corticosteroids, and antiarrhythmic drugs. 4. Treatment with Investigational and antiviral therapy in a clinical study within one month before randomization. 5. History of allergy to Licorice. 6. Pregnancy and breastfeeding. INTERVENTION AND COMPARATOR: Intervention group: The standard treatment regimen for COVID-19 along with a Licorice-based herbal preparation (D-Reglis ®, Irandarouk Pharmaceutical Company, Iran) at a dose of 760 mg three times a day for a period of seven days. CONTROL GROUP: The standard treatment for COVID-19 based on the Iranian Ministry of Health and Medical Education's protocol for a period of seven days. MAIN OUTCOMES: The recovery rate of clinical symptoms, including fever, dry cough, and tiredness, as well as paraclinical features, including thrombocytopenia, lymphocytopenia, and C-reactive protein, are evaluated as primary outcomes within seven days of randomization. Time to improvement of clinical and paraclinical features and length of stay in a hospital, along with the incidence of adverse reactions are also evaluated as the secondary outcomes within seven days of randomization. RANDOMIZATION: An electronic table of random numbers will be used to allocate the included participants into either control or intervention groups (in a 1:1 ratio) using the simple randomization method. BLINDING (MASKING): This is an open-label trial without blinding and placebo control. NUMBERS TO BE RANDOMIZED (SAMPLE SIZE): A total of 60 participants randomizes (30 patients allocated to the intervention group and 30 patients allocated to the control group). TRIAL STATUS: The protocol is Version 1.0, May 31, 2020. Recruitment began July 30, 2020, and is anticipated to be completed by October 30, 2020. TRIAL REGISTRATION: This clinical trial has been registered in the Iranian Registry of Clinical Trials (IRCT). The registration number is "IRCT20200506047323N2", https://www.irct.ir/trial/47990 . The registration date is 31 May 2020. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.