Development and characterization of a spark plasma device designed for medical and aesthetic applications.

Cold atmospheric plasma devices have shown high potential to be useful for different medical applications. In this study, it has been tried to develop and characterize a cold atmospheric spark plasma device that can be used safely as a tool for medical and aesthetic applications. The schematic of the device is presented in the paper, and the signals of each block are also tested. A special handpiece for this device is designed to make the device as safe as possible. The device's properties that can impose a risk to users' health have been under consideration. The device's electrical properties have been tested, and results show that the electrical current of the device is below the safety thresholds and can be used safely. The radiation power of the device also has been tested. It is shown that the time needed for the radiation power to reach the danger threshold is much longer than the treatment time. The device will not impose any risk regarding radiation from the UV spectrum. Optical emission spectroscopy is also used to investigate the neutral and charged species that are the by-products of electrical discharge. The presence of NOx and OH locally in the discharge can be helpful for various medical applications. This paper presents one of the first studies conducted to investigate the engineering aspect and the immunometry of the spark plasma that can be used in medicine and other purposes.

What factors influence couples' decisions to have children? Evidence from a systematic scoping review.

BACKGROUND: One of the most significant demographic challenges over the past three decades has been the substantial reduction in fertility rates, worldwidely. As a developing country, Iran has also experienced a rapid decline in fertility over the past decades. Understanding factors influencing fertility is essential for development programs. Moreover, it's crucial to study the parameters that affect the intention for childbearing in any society. Therefore, through a systematic scoping review, the present study investigates the factors influencing couples' decisions toward childbearing. METHODS: This study was a systematic scoping review conducted in 2023. To design and conduct this scoping review, Joanna Briggs Institute's Protocol (Institute TJB, The Joanna Briggs Institute Reviewers ' manual 2015; methodology for JBI scoping reviews, 2015) was used and the framework presented by Levac et al. (2010) was also used as a guide for conducting this review. Studies were searched in three main databases including ISI Web of Sciences, PubMed, and Scopus, using a predefined search strategy. Google Scholar was also used for complementary search. The search period was from 2002 to 2022. RESULTS: A total of 18,454 studies were identified across three primary databases. After evaluating articles in three distinct phases based on title, abstract, and full-text, 46 articles were deemed eligible for inclusion in the scoping review. The qualitative analysis of the collected data from the selected studies through the scoping review led to classifying factors influencing households' desire for childbearing into eight main themes and 101 sub-themes. The main themes associated with factors impacting households' intention for childbearing encompass individual determinants, demographic and familial influencing factors, cultural elements, social factors, health-related aspects, economic considerations, insurance-related variables, and government support/incentive policies. CONCLUSIONS: Comprehensive and holistic attention from governments and officials toward the various factors affecting households' intention and behavior regarding childbearing appears beneficial and effective. Furthermore, given the relative ineffectiveness of some of the current government's supportive/incentive policies to increase couples' desire for childbearing, it seems necessary to review and amend these policies. This review should address the most significant challenges and factors contributing to couples' reluctance to childbearing or strengthen factors that can play a substantial role in fostering fertility and childbearing desires.

Metabolic syndrome: a population-based study of prevalence and risk factors.

The association between personal habits and metabolic syndrome (MetS) remains controversial. This study aimed to assess the prevalence of MetS among youths and its association with cigarette, tobacco, opium, and alcohol consumption in the Rafsanjan Youth Cohort Study (RYCS). The current cross-sectional study was based on data from RYCS, as part of the Rafsanjan Cohort Study (RCS). RCS is a branch of the prospective epidemiological research studies in Iran (PERSIAN). In the present study, 2843 youths aged 15-35 were included. MetS was diagnosed using the international diabetes federation (International IDF), National Cholesterol Education Panel- Adult Treatment Panel III (NCEP-ATPIII), and Iranian criteria (IDF Iranian). Binary logistic regression models were performed to estimate odds ratios (ORs) and confidence intervals (CIs). The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS according to international IDF and Iranian IDF in the alcohol-drinking group in the last 12 months (OR: 1.51, 95%CI 1.02-2.21, OR: 1.66, 95%CI 1.11-2.48 respectively) were greater compared with the non-drinking group. The odds of having high TG in the alcohol-drinking group in the last 12 months was 1.53 times higher than the control group (OR = 1.53, 95% CI: 1.20-1.94). Furthermore, the odds of having high waist circumference (WC) according to IDF International was significantly higher in the tobacco-smoking group in the last 12 months and in the tobacco-smoking group in the last 12 months daily (OR: 1.23, 95%CI 1.01-1.49 and OR: 1.41, 95%CI 1.01-1.98 respectively) compared to the control groups. The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS and high TG were greater in the alcohol-drinking group in the last 12 months compared with the non-drinking group. The odds of high WC in the last 12 months, were greater in the tobacco-smoking group compared with the non-smoking group. However, more longitudinal studies are needed to verify the associations observed in the current study.

Natural Flavonoid Apigenin, an Effective Agent Against Nervous System Cancers.

Cancer is a serious public health concern worldwide, and nervous system (NS) cancers are among the most life-threatening malignancies. Efforts have been devoted to introduce natural anticancer agents with minimal side effects. Apigenin is an edible flavonoid that is abundantly found in many vegetables and fruits. Various pharmaceutical activities, including anti-inflammatory, antioxidative, antimicrobial, and anticancer effects have been reported for apigenin. This review provides insights into the therapeutic effects of apigenin and flavonoids with similar structure on glioblastoma and neuroblastoma. Current evidence indicates that apigenin has the unique ability to cross the blood-brain barrier, and its antioxidative, anti-inflammatory, neurogenic, and neuroprotective effects have made this flavonoid a great option for the treatment of neurodegenerative disorders. Meanwhile, apigenin has low toxicity on normal neuronal cells, while induces cytotoxicity on NS cancer cells via triggering several signal pathways and molecular targets. Anticancer effects of apigenin have been contributed to various mechanisms such as induction of cell cycle arrest and apoptosis, and inhibition of migration, invasion, and angiogenesis. Although apigenin is a promising pharmaceutical agent, its low bioavailability is an important issue that must be solved before introducing to clinic. Recently, nano-delivery of apigenin by liposomes and poly lactic-co-glycolide nanoparticles has greatly improved functionality of this agent. Hence, investigating pharmaceutical effects of apigenin-loaded nanocarriers on NS cancer cell lines and animal models is recommended for future studies.

Quality of in-hospital care in traumatic spinal column and cord injuries (TSC/SCI) in I.R Iran.

PURPOSE: This study aimed to implement the Quality of Care (QoC) Assessment Tool from the National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) to map the current state of in-hospital QoC of individuals with Traumatic Spinal Column and Cord Injuries (TSCCI). METHODS: The QoC Assessment Tool, developed from a scoping review of the literature, was implemented in NSCIR-IR. We collected the required data from two primary sources. Questions regarding health system structures and care processes were completed by the registrar nurse reviewing the hospital records. Questions regarding patient outcomes were gathered through patient interviews. RESULTS: We registered 2812 patients with TSCCI over six years from eight referral hospitals in NSCIR-IR. The median length of stay in the general hospital and intensive care unit was four and five days, respectively. During hospitalization 4.2% of patients developed pressure ulcers, 83.5% of patients reported satisfactory pain control and none had symptomatic urinary tract infections. 100%, 80%, and 90% of SCI registration centers had 24/7 access to CT scans, MRI scans, and operating rooms, respectively. Only 18.8% of patients who needed surgery underwent a surgical operation in the first 24 h after admission. In-hospital mortality rate for patients with SCI was 19.3%. CONCLUSION: Our study showed that the current in-hospital care of our patients with TSCCI is acceptable in terms of pain control, structure and length of stay and poor regarding in-hospital mortality rate and timeliness. We must continue to work on lowering rates of pressure sores, as well as delays in decompression surgery and fatalities.

Adjustment for collider bias in the hospitalized Covid-19 setting.

Background: Causal directed acyclic graphs (cDAGs) are frequently used to identify confounding and collider bias. We demonstrate how to use causal directed acyclic graphs to adjust for collider bias in the hospitalized Covid-19 setting. Materials and methods: According to the cDAGs, three types of modeling have been performed. In model 1, only vaccination is entered as an independent variable. In model 2, in addition to vaccination, age is entered the model to adjust for collider bias due to the conditioning of hospitalization. In model 3, comorbidities are also included for adjustment of collider bias due to the conditioning of hospitalization in different biasing paths intercepting age and comorbidities. Results: There was no evidence of the effect of vaccination on preventing death due to Covid-19 in model 1. In the second model, where age was included as a covariate, a protective role for vaccination became evident. In model 3, after including chronic diseases as other covariates, the protective effect was slightly strengthened. Conclusion: Studying hospitalized patients is subject to collider-stratification bias. Like confounding, this type of selection bias can be adjusted for by inclusion of the risk factors of the outcome which also affect hospitalization in the regression model.

Post-discharge follow-up of patients with spine trauma in the National Spinal Cord Injury Registry of Iran during the COVID-19 pandemic: Challenges and lessons learned.

PURPOSE: The purpose of the National Spinal Cord Injury Registry of Iran (NSCIR-IR) is to create an infrastructure to assess the quality of care for spine trauma and in this study, we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these patients. METHODS: An observational prospective study was conducted from April 11, 2021 to April 22, 2022 in 8 centers enrolled in NSCIR-IR, respectively Arak, Rasht, Urmia, Shahroud, Yazd, Kashan, Tabriz, and Tehran. Patients were classified into three groups based on their need for care resources, respectively: (1) non-spinal cord injury (SCI) patients without surgery (group 1), (2) non-SCI patients with surgery (group 2), and (3) SCI patients (group 3). The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases: pre-hospital, in-hospital, and post-hospital. The data from the first 2 phases were collected through the registry. The post-hospital data were collected by conducting follow-up assessments. Telephone follow-ups were conducted for groups 1 and 2 (non-SCI patients), while group 3 (SCI patients) had a face-to-face visit. This study took place during the COVID-19 pandemic. Data on age and time interval from injury to follow-up were expressed as mean ± standard deviation (SD) and response rate and follow-up loss as a percentage. RESULTS: Altogether 1538 telephone follow-up records related to 1292 patients were registered in the NSCIR-IR. Of the total calls, 918 (71.05%) were related to successful follow-ups, but 38 cases died and thus were excluded from data analysis. In the end, post-hospital data from 880 patients alive were gathered. The success rate of follow-ups by telephone for groups 1 and 2 was 73.38% and 67.05% respectively, compared to 66.67% by face-to-face visits for group 3, which was very hard during the COVID-19 pandemic. The data completion rate after discharge ranged from 48% to 100%, 22%-100% and 29%-100% for groups 1 - 3. CONCLUSIONS: To improve patient accessibility, NSCIR-IR should take measures during data gathering to increase the accuracy of registered contact information. Regarding the loss to follow-ups of SCI patients, NSCIR-IR should find strategies for remote assessment or motivate them to participate in follow-ups through, for example, providing transportation facilities or financial support.

The trend of marriage, childbearing, and divorce and its determinants of socio-economic factors on divorce in Yazd province 2016-2021: A cross-sectional study.

Background: In recent decades, families and their stability as an important social institution have changed significantly. Objective: This study aimed to investigate the marriage trends, childbearing, and divorce changes in Yazd province from 2016 to 2021 to estimate the effect of socioeconomic factors on divorce. Materials and Methods: A cross-sectional study was done in 2 phases. In the first phase, an ecological (time trend) was conducted to investigate the 5 yr trend in the occurrence of marriage, childbearing, and divorce, as well as the factors affecting the occurrence of divorce in the second phase. For the second phase of the study, 600 participants were selected. 300 divorced and 300 married applicants were chosen between 2016 and 2021. A binary logistic regression model was used to find the related factors affecting the occurrence of divorce. Results: The results showed a declining marriage (p = 0.05) and childbearing trend (p = 0.84), as well as an increasing trend in divorces (p = 0.02) in Yazd. Logistic regression analysis showed that college education (OR = 0.22, CI: 0.116-0.430, p < 0.001) and being self-employed (OR = 0.48, CI: 0.255-0.934, p = 0.03) could reduce the odds of divorce. In addition, nonresidents (OR = 2.1, CI: 1.314-3.562, p < 0.001), with > 10-yr age differences (OR = 3.8, CI: 1.803-8.213, p < 0.001) or the woman being older than her husband (OR = 3.4, CI: 1.981-5.848, p < 0.001) could increase the odds of divorce. Conclusion: Our results confirmed that a combination of socioeconomic characteristics affects the stability of family institutions.

COVID-19 vaccine in pregnant women and pregnancy outcomes: A historical cohort in center of Iran.

BACKGROUND: Starting vaccination in pregnant women; numerous theories have been proposed that the vaccine might affect the mother or the fetus. OBJECTIVE: The goal of this research was to see whether there was a link between the Sinopharm vaccination and certain pregnancy outcomes in COVID-19-vaccinated women. STUDY DESIGN: This is a retrospective cohort study. METHOD: This study was conducted on pregnant women who delivered from 1 August 2021 to 1 January 2022 in Yazd city. We have followed the STROBE Guidelines when preparing the manuscript. In this period time, all pregnant women were 5787 people in which 5666 were in the second and third trimester. Among these women, 1222 women were randomly selected. RESULTS: Among 1222 pregnant women, 558 (45.6%) women had received one dose vaccine, 162 (13.3%) people had received two doses, and 502 (41.1%) women had not been vaccinated. On crude analysis, there was no significant difference between vaccinated and non-vaccinated groups. After adjusting for maternal age, maternal body mass index, parity, stillbirth history, abortion history, and gestational diabetes in multivariate analysis, no differences were found between the groups in pregnancy as well. CONCLUSION: Vaccinations during pregnancy seem to have no negative effects on the mother or the baby. This finding may aid pregnant women in deciding whether or not to take the vaccination.

Validation and psychometric properties of the Persian version of the MISSCARE survey.

AIM: To conduct, translate, and psychometric evaluation of the MISSCARE-Persian Survey. DESIGN: A cross-sectional study was conducted in Iran in February-June 2021. METHODS: The translation of the MISSCARE Survey was accomplished according to World Health Organization (WHO) guidelines. Construct validity was performed by (N = 300) exploratory factor analysis and confirmation. To assess the reliability, internal consistency was assessed using Cronbach's alpha coefficient, and relative stability was assessed using the interclass correlation coefficient (ICC). The study adhered to COSMIN guidelines. RESULTS: The exploratory factor analysis, which resulted in the identification of three factors in the second part of the tool, explained 79.6% of the total variance. Confirmatory factor analysis indicated the model's good fit of information. The reliability of the first and second parts of the tool was 0.912 and 0.901, respectively. Additionally, the ICC was found to be 0.687 for the first and 0.706 for the second part of the tool.

Effect of treatment regimen of the rheumatoid arthritis patients on the risk of coronavirus disease 2019 by modulating the inflammatory mediators.

BACKGROUND: The therapeutic profile of the patients with rheumatoid arthritis (RA) commonly consists of immunosuppressive and anti-inflammatory compounds. Here in this research, we assessed the potential effect of drug treatment in the RA patients in increasing the risk of coronavirus disease 2019 (COVID-19) infection. METHODS: In this retrospective cross-sectional study, 200 subjects with RA were recruited. The treatment profile of the subjects for the past 6 months was collected. The COVID-19 diagnosis was implemented based on the standard molecular tests and clinical examinations. Serum concentration of cytokines was measured using enzyme-linked immunosorbent assay (ELISA). RESULTS: It was detected that there was an increased risk of COVID-19 in RA subjects receiving Etanercept (OR = 3.51, 95% CI 1.19-10.30, P = 0.022). Concentrations of Interleukin (IL)-1ß, Interferon (IFN)-γ, Tumor necrosis factor (TNF)-α, IL-6, IL-17A, and IL-23 were significantly higher in the RA patients with COVID-19 relative to RA cases without COVID-19. In RA/COVID-19 cases receiving Etanercept, serum levels of TNF-α, IL-1ß, and IL-6 were significantly lower than RA/COVID-19 subjects without Etanercept therapy. CONCLUSIONS: It seems that Etanercept therapy in RA cases might increase proneness of the COVID-19 risk in these cases. The mechanism of this increased risk may stem from suppressing a protective immunity state in the RA cases.

Flavonoids in Combination with Stem Cells for the Treatment of Neurological Disorders.

Neurological disorders are the leading cause of disability and the world's second leading cause of death. Despite the availability of significant knowledge to reduce the burden of some neurological disorders, various studies are exploring more effective treatment options. While the human body can repair and regenerate damaged tissue through stem cell recruitment, nerve regeneration in case of injury is minimal due to the restriction on the location of nerve stem cells. Recently, different types of stem cells extracted from various tissues have been used in combination with natural stimuli to treat neurologic disorders in neuronal tissue engineering. Flavonoids are polyphenolic compounds that can induce the differentiation of stem cells into neurons and stimulate stem cell proliferation, migration, and survival. They can also increase the secretion of nutritional factors from stem cells. In addition to the effects that flavonoids can have on stem cells, they can also have beneficial therapeutic effects on the nervous system alone. Therefore, the simultaneous use of these compounds and stem cells can multiply the therapeutic effect. In this review, we first introduce flavonoid compounds and provide background information on stem cells. We then compile available reports on the effects of flavonoids on stem cells for the treatment of neurological disorders.

Association between metabolic syndrome and stroke: a population based cohort study.

Both metabolic syndrome (MetS) and stroke are associated with increased risk of mortality. Here, we aimed to assess the prevalence of MetS among adults using three definitions (Adult Treatment Panel III (ATP-III), International Diabetes Federation (IDF) and IDF ethnic specific cut-off for Iranian criteria) and its association with stroke. We performed a cross-sectional study of a total of 9991 adult participants of Rafsanjan Cohort Study (RCS), as part of the Prospective epidemiological research studies in Iran (PERSIAN cohort study). The MetS prevalence was evaluated in participants according to the different criteria. Multivariate logistic regression analyses were conducted to assess the association between three definitions of MetS with stroke. We found that MetS was significantly associated with higher odds of stroke according to NCEP-ATP III (odds ratio (OR): 1.89, 95% confidence interval (CI) 1.30-2.74), international IDF (OR:1.66, 95% CI: 1.15-2.40) and Iranian IDF (OR:1.48, 95% CI: 1.04-2.09) after adjusted for variables confounders. Furthermore, after adjustment, in receiver operating characteristic (ROC) curve, the AUROC was 0.79 (95% CI = 0.75-0.82), 0.78(95% CI = 0.74-0.82) and 0.78(95% CI = 0.74-0.81) for presence of MetS according to NCEP-ATP III, international IDF and Iranian IDF, respectively. ROC analyses revealed that all of these three criteria for MetS are "moderately accurate" for the identification of increased stroke risk.In conclusion, our results showed that MetS was associated with increased odds of stroke. Our findings implicate the importance of early identification, treatment, and ultimately prevention of the metabolic syndrome.

Development and validation of a questionnaire based on the protection motivation theory to predict cigarette smoking preventive behavior in the Iranian university students.

BACKGROUND: Prevention of smoking is very important at a young age and during the student period. Because of the lack of a questionnaire based on the prevention of smoking behavior, this study was conducted to design and standardize a tool according to the protection motivation theory (PMT). MATERIALS AND METHODS: This was an analytical cross-sectional study where information and opinions of experts and then designing tools and assessing the face validity in the first phase and content validity, construct validity, test-retest reliability, and internal consistency of questions in the second phase were examined. The initial themes and structures were determined based on the literature Review and the opinion of experts. Three hundred students of Yazd Universities were selected by cluster sampling and included in the study. All analyses were performed in SPSS and AMOS software version 24 with a significance level of less than 5%. RESULTS: The final version of the scale had 39 questions in eight dimensions. The overall Cronbach's alpha value was 0.89, and for each dimension, it was more than 0.7. The content validity ratio and content validity index for the whole tool were 0.87 and 0.94, respectively. The results of confirmatory factor analysis showed that the latent construct model had good fit (X2/df = 4.31; RMSEA = 0.07; CFI = 0.94; NFI = 0.92; TLI = 0.91, P < 0.001). CONCLUSION: In this study, a valid and reliable tool based on PMT to predict smoking behavior in students was introduced. This tool can be used in interventional and etiological studies. It also has questions related to the coronavirus disease 2019 (Covid 19) virus and can be used in the coronavirus pandemic.

Assessment of the relationship between vitamin D with semen analysis parameters and reproductive hormones levels before and after kidney transplantation: An Iranian randomized and double-blinded study.

BACKGROUND: Vitamin D's role is noticeable on homeostasis of calcium and phosphorous and bone mineralization. Some studies prove that vitamin D has a role in reproductive pathways in male and females and its direct relationship with serum androgen levels in males. The common problem of infertility can be seen in 10%-15% of couples. 25%-50% of all infertilities is due to a male factor, and fertility disturbances are common in male CKD patients. OBJECTIVES: This study aimed to figure out the effect of serum vitamin D levels on semen analysis parameters and reproductive hormones before and after renal transplantation in ESRD patients. METHODS: This double-blind randomized clinical trial was carried out on 70 ESRD males (21-48 years old) who were candidates for renal transplantation at Sina hospital between 2021 and 2022. Participants were divided into two groups randomly. First group was supplemented by vitamin D (50,000 units weakly until 3 months), and no intervention was done in the second group. Vitamin D levels, LH, FSH, creatinine, glomerular filtration rate (GFR), calcium, total and free testosterone, PTH, sexual function, and semen analysis parameters were evaluated in a determined interval before and after (three and 6 months) kidney transplantation. RESULTS: Vitamin D levels were noticeably higher in case group in comparison to the control group (p-value < 0.01) but the difference in all other variables including calcium levels, LH, FSH, total and free testosterone, IIEF-5 score, PTH, GFR, and creatinine was insignificant (p-value > 0.05). The comparison of semen parameters of the case with control group including sperm count, morphology, volume, and motility didn't reveal a noticeable difference between the two groups (p-value > 0.05). CONCLUSION: Prescription of vitamin D as a supplementation doesn't improve sperm quality (sperm count, motility, morphology, and volume) and reproductive hormones (LH, FSH, free and total testosterone) after kidney transplantation in male CKD patients.

Examination of the Topical Effect of the Combination of Plantago ovata and Vinegar on the Improvement of Rural Cutaneous Leishmaniasis Lesions.

Background: The present study aimed at investigating the topical effect of the combination of Plantago ovata and vinegar on the improvement of rural cutaneous leishmaniasis lesions. Materials and Methods: The present randomized double-blind controlled clinical trial was performed on 42 patients with rural skin leishmaniasis. In the case group, in addition to injecting glucantime into the lesion according to the latest national instructions, a combination of P. ovata and vinegar was applied topically twice a day for 8 weeks. In the control group, only glucantime injection into the lesion was performed for 8 weeks according to the latest national guidelines. At the end of the 1st, 2nd, 3rd, 4th, 8th, and 12th weeks after the intervention, the lesion area and improvement were evaluated and recorded. Results: The results of the present study indicated the lesion area in the case group with the mean of 0.35 ± 0.39 cm and 0.18 ± 0.27 cm in the 8th and 12th weeks, respectively was significantly less than that of the control group with the mean of 0.64 ± 0.78 cm and 0.56 ± 0.44, respectively (P < 0.05). Twelve weeks after the intervention, 84.1% of the lesions in the case group and 65.9% of the lesions in the control group were completely improved (P < 0.05). Conclusion: According to the results of the present study, the improvement of leishmaniasis lesion with the topical application of the combination of P. ovata and vinegar was significantly more than that of the control group in the 8th and 12th weeks after the intervention.

Clinical courses of 24,563 hospitalized COVID-19 patients during the first 12 months of the pandemic in the Central City of Iran.

This study was designed and implemented to analyze and establish documents related to the above cases in the first to third COVID-19 epidemic waves for the use of researchers and doctors during and after the epidemic. The current case series study was conducted on 24,563 thousand hospitalized COVID-19 patients by examining their clinical characteristics within a one-year period from the beginning of the pandemic on 02.22.2020 to 02.14.2021, which included the first to the third waves, based on gender and severity of COVID-19. The mean age of the participants was 56 ± 20.71, and 51.8% were male. Out of a total of 24,563 thousand hospitalized COVID-19 patients until February 2021, there were 2185 mortalities (9.8%) and 2559 cases of severe COVID-19 (13.1%). The median length of hospitalization from the time of admission to discharge or death in the hospital (IQR: 13-41) was estimated to be 21 days. The rate of hospital mortality was higher in severe (37.8%) than in non-severe (4.8%) cases of COVID-19, While the risk of severe cases increased significantly in the third (HR = 1.65, 95% CI: 1.46-1.87, P < 0.001) and early fourth waves (HR = 2.145, 95% CI: 1.7-2.71, P < 0.001). Also, the risk of contracting severe COVID-19 increased significantly in patients aged ≥ 65 years old (HR = 2.1, 95% CI 1.1.93-2.72, P < 0.001). As shown by the results, the rates of hospital mortality (9.3% vs. 8.5%) and severe cases of COVID-19 (13.6% vs. 12.5%) were higher among men than women (P < 0.01). In our study, the mortality rate and severity of COVID-19 were within the scope of global studies. Men experienced higher severity and mortality than women. The was a significantly higher prevalence of old age and underlying diseases in individuals with severe COVID-19. Our data also showed that patients with a previous history of COVID-19 had a more severe experience of COVID-19, while most of these patients were also significantly older and had an underlying disease.

The role of interleukins in pathogenesis and prognosis of atrial fibrillation.

INTRODUCTION: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia. Moreover, it is mentioned as one of the important causes of death due to heart disease, which imposes an undeniable financial burden on public health systems. Almost 1 out of 4 individuals aged 40 to 55 will experience AF at some point during their life. Increasing the pressure or the volume of the atria over time leads to the activation of fibroblasts, resulting in the accumulation of extracellular matrix and fibrosis. By disturbing electrical conduction, fibrosis creates microreentrant circuits, which can develop into AF. AREAS COVERED: In this article, we evaluated the vital role of interleukins and inflammatory mediators in the pathogenesis, prognosis, and treatment of AF. We also discussed the importance of the broader use of interleukins in the clinical management of AF patients. EXPERT OPINION: Interleukins and inflammatory markers can be used as markers of diagnosis, cardiovascular events, and mortality in AF patients. Finally, the utilization of substances upregulating IL-10, such as resolvin D1 (RvD1), or applying IL-6 down-regulators and inhibitors, including anti-IL-6 antibodies, colchicine, and C1q/tumor necrosis factor-related protein-9 (CTRP9), are effective in the reduction of atrial interstitial fibrosis and treating AF patients.

Interleukins are mediators of the immune system, which play vital roles, directly or indirectly, in many immune responses and have a wide range of effects on the systems in the body. Similarly, these interleukins can have versatile roles in igniting or attenuating cardiovascular disorders. However, due to the complexity and variability of their effects on the cardiovascular system, research is still ongoing to capture a complete and realistic image of the role of interleukins in the development of cardiovascular disorders. Atrial fibrillation occurs following the irregular rhythm of the beat in the atria. Subsequently, the normal blood flow from the atria to the ventricles will be disturbed. Atrial fibrillation is the most common heart arrhythmia that might need medical care. However, the probability of severe atrial fibrillation outcomes or symptoms is higher in people with underlying comorbidities. This review investigates the role of interleukins in the occurrence of atrial fibrillation and its long-term complications. Atrial fibrillation usually begins as occasional brief episodes that start and stop spontaneously, but it can progress to more persistent forms that are associated with an increased risk of stroke and heart failure.. Interleukins and inflammatory mediators can enhance atrial fibrillation by worsening the conductance of the electrical signal and by boosting the fibrogenesis and structural remodeling of the atria. Currently, based on the role of interleukins in atrial fibrillation, therapeutic methods are being developed to prevent and attenuate its serious consequences. These therapeutic methods can impressively affect and improve the lives of millions of people suffering from this disorder. [Figure: see text].

Symptomatic kidney stones in an anuric patient on dialysis: A case report.

INTRODUCTION: Renal colic is a colicky-type of flank pain that can commonly be presented in patients undergoing dialysis especially if they are anuric considering the fact that there are multiple controversies and little published experience on this topic, we found it very important to report this case. We also aimed to increase awareness and emphasize the importance of renal colic in anuric patients on dialysis. CASE DESCRIPTION: We herein report a case of a 42-year old man with a chief complaint of bilateral colic flank pain, He had developed end stage renal disease due to ADPKD and was on hemodialysis since the past 5 years. Previously, he went through a series of workup but was left undiagnosed. Abdomen-pelvic and chest CT scan without contrast was performed showing bilateral renal pelvic stones and some nephrocalcinosis in both kidneys. bilateral ureteroscopy was performed and bilateral DJ was installed for a total of 6 weeks and extracorporeal shock wave lithotripsy was done. With prompt diagnosis, the patient was pain free and stone free before discharge. The patient is also reported to be stone free 6 months after the procedure. CONCLUSION: Patients on dialysis are still capable of forming symptomatic renal tract stones even if they are anuric.

Impact of social and cultural factors on incidence, transmission and control of Coronavirus disease in Iran: a qualitative study.

INTRODUCTION: COVID-19 pandemic has had mixed reactions from nations, people and governments about ways to cope with, prevent and control the disease. The current study identifies social, cultural and policy factors affecting the incidence and control of Coronavirus disease in Iran. METHODS: A qualitative study consists of content analysis as well as the views of 20 experienced and knowledgeable subjects specialized in social and cultural health management. The data were gathered using three semi-structured interviews and then continued by 17 semi-structured interviews. Data analysis was done using Graneheim approach. After each interview, the recorded audio files transcript and reviewed. Then codes extracted and divided to categories and sub-categories. RESULTS: There are distinct social and cultural factors in coping with Coronavirus disease. These consisted of three categories of governance, individual and community related factors. A total of 17 subcategories and 215 primary codes that were extracted from the text of interviews as variables of the study and in relation to the research question. Ten subdomains of governance including vaccination, political issues, knowledge, support services, administrative services, transportation, health and treatment, culturalization, legislation and, managerial and financial policies impacted the spread and mitigation of the pandemic at various levels. CONCLUSION: The management of pandemics requires a comprehensive capacity for identifying and determining social and cultural criteria. A healthy partnership between governments and the community may be required to remove unnecessary obstacles that hinder public health attempt to alleviate the risk. The obtained criteria and indicators from this study may be utilized by policy makers in an attempt to strengthen protocols for mitigating pandemics. Further studies may be warranted to confirm these findings.