Iranian Red Crescent Medical Journal
Year:2020 | Volume:22 | Issue:3|Papers Count:12

Background: The materials science may come to assist pharmacists to fabricate new drugs for coronavirus disease 2019 (COVID-19). Objectives: The geometrical structure of elements on the surface of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is analyzed to illustrate some hints about the possible choosing the factors captivating the surface of SARS-CoV-2. Methods: The crystallographic classes and their sub-structures can be indicative of practical selection of macromolecules in drug pharmacy. Results: The macromolecular structures with hexagonal and its sub-structures are suggested for pharmacists to probe a novel drug for COVID-19. Conclusions: Any progress in the field of fabricating macromolecular drugs for COVID-19 is strongly dependent on finding the hexagonal and its sub-structures such as triangular and rhombus geometries.

Background: Falling is a major problem in older adults. Transcranial direct current stimulation (tDCS) is a neuromodulation technique to improve balance in the elderly. The majority of previous studies have assessed the effects of cerebellar and primary motor cortex (M1) tDCS, while less attention has been paid to the comparison of the effects of tDCS in these two regions. Objectives: The goal of this study was to compare the effectiveness of cerebellum and M1 tDCS on the balance in older adults. Methods: In this double-blind sham-controlled crossover study, a total of 32 healthy older adults were randomly assigned to two groups of M1 and cerebellum tDCS. Each group received active and sham stimulation with a crossover design within a one-week interval. The intensity and duration of tDCS were 2mAand 20 minutes, respectively. Before and after each session, the total path length (TPL) andmeanvelocity (MV) of the center of pressure were determined using a force plate in both mediolateral and anteroposterior directions under single-task and dual-task conditions. Results: The results of mixed ANOVA test showed that the main effect of time on TPL and MV was significant in both mediolateral (P < 0. 01) and anteroposterior (P = 0. 01) directions. The interaction between time and stimulation was also significant on TPL and MV in both mediolateral (P < 0. 001) and anteroposterior (P < 0. 001) directions. The between-group analysis showed no significant difference in the efficacy of cerebellar and M1 tDCS in the mediolateral (P = 0. 79) and anteroposterior (P = 0. 60) directions. Conclusions: Anodal tDCS of the cerebellum and M1 could improve the postural balance indices in healthy older adults. These two techniques exerted similar effects on static balance.

Background: Psychological factors play important roles in mental and physical outcomes of cancer, like disability and positive growth after exposure to cancer trauma. Objectives: This study aimed to investigate the mediating role of health literacy in the relationship of social support and coping strategies with post-traumatic growth and functional disability among patients with cancer. Methods: The present descriptive, cross-sectional study included 265 patients (142womenand 123 men) with various types of cancer selected by a convenience sampling method among patients referring to the Cancer Clinics of Imam Khomeini Hospital in Tehran, Iran. Data were collected by the “ WHO Disability Assessment schedule” , “ post-traumatic growth inventory” , “ Functional, Communicative, and Critical Health Literacy scale” , “ Social Support scale” , and “ Brief Cope scale” . Data were analyzed by structural equation modeling (SEM) using AMOS-24 and SPSS-20 software. Results: The results showed that social support had a significant positive correlation with post-traumatic growth (P 0. 001) and health literacy (P 0. 001) and a significant negative correlation with functional disability (P 0. 001). There was a significant positive correlation between avoidance-coping strategies and post-traumatic growth (P 0. 001) and functional disability (P 0. 051). Problem-focused coping strategies had a significant positive correlation with health literacy (P 0. 051) and there was a significant negative correlation between health literacy and functional disability (P 0. 001). Additionally, health literacy had a mediating role in the relationship between social support and functional disability (P  0. 001) and between problem-focused coping strategies and functional disability (P 0. 001). Conclusions: Social support and coping strategies directly or through the mediating role of health literacy are important predictors of post-traumatic growth and functional disability among patients with cancer, suggesting the need for intervening and educating in these areas to improve patients’ physical and mental status.

Background: The expansion of activities and performance areas of organizations and modern management issues imply that organizations are no longer satisfied with success in only a limited number of elements. Mathematical models, thus, were formed and gradually developed for assessing organizations and providing the right tools. Objectives: This study was conducted to provide a model for improving the quality of services to patients with cataracts. Methods: The study population consisted of 20 experts in health service management in one group and 396 patients in another group. The data were used for the Importance-Performance Analysis (IPA). The first group consisted of 20 experts selected for the localization of the quality of services and the ISM. This applied descriptive-analytical study used the Fuzzy Delphi method for selecting the elements of the quality of services, the importance-performance analysis for identifying the strengths and weaknesses of these elements, and the Interpretive-Structural modeling for improving the elements of the quality of services by prioritizing the effect of the factors. Results: The eye hospital has to pay immediate attention to elements including “ reliability” , “ support services” , “ knowledge of personnel” , “ waiting time” , “ assurance” , “ sympathy” , “ decorum and modesty” , “ understanding the patients” , “ patients’ safety” , “ continuous services” , “ complaints management” , “ cleanness/tidiness of environment, ” and “ rapid provision of services” to improve the quality of its services. Conclusions: Interpretive structural modeling showed that two variables “ technology and innovation” and “ reliability” acted as the cornerstone of the model and they should be emphasized first and foremost for the system to begin functioning.

Background: Acute appendicitis is one the most common and sometimes life threatening conditions in the Emergency Department referrals. Since suspected cases of acute appendicitis require immediate diagnosis and proper intervention, the computed tomography (CT) scan becomes the most frequently used modality for such conditions. However, due to the nature of emergency wards, gastrointestinal (GI) expert radiologists may not be always available. Objectives: The current study aimed at comparing the interobserver variability of GI expert radiologists, general radiologists, and radiology residents in in CT-scan interpretation of cases suspected of acute appendicitis. Methods: Seventy patients suspected of acute appendicitis admitted to the Emergency Department of our university hospital were included in the study. CT-scan with intravenous contrast was performed on patients that their Alvarado score ranged 5 to 8. Decision for surgical or non-surgical management of patients was made by the routine treatment team of hospital and retrospectively, CTscan images of all 70 patients were reported blindly by three groups of radiologists. Results: Out of the 70 cases, 48 had positive confirmatory pathology for appendicitis (69%) and 22 had negative pathology report (31%). The sensitivity of the reports for radiology residents, general radiologists, and GI expert radiologists was 81. 3%, 93. 8% and 95. 8%, respectively. The specificity of the diagnosis in the three groups was 72. 7%, 86. 4% and 81. 8%, respectively. Conclusions: The study results showed that although the interpretation was not perfect, radiology residents and general radiologists can provide reports with acceptable sensitivity and specificity in the emergency ward.

Background: Health survey is one of the important and valuable methods in producing health indicators and has become a part of health information system. Health surveys planned and performed properly can be used in assessing population health, policymaking, planning, health monitoring, evaluating, and observatories. Objectives: The present paper is the product of a project to establish a calendar for health observatory studies, which has to compatible with Iran’ s Sustainable Development Plans. Methods: The main question of this qualitative study was: “ what are the reasons and solutions for having up-to-date, sufficient, quality information, and how could we ensure they are being carried out? ” Data collection methods included interviews, reviewing documents and records, and interviewing focus groups of Iranian experts and health policy-makers. Results: Thirty-one health observatory studies, concurrent with Iran’ s five-year Socioeconomic Development Plans, passed the consensus of stakeholders. The span of time to conduct each study was determined based on five-year Development Plans and national and international organizations’ requests for certain information. Conclusions: If the policy-makers are constantly pleased with up-to-date, sufficient, and quality information, sustainability of sticking to this calendar can be secured. The effective factors in successful implementation of this calendar is timely financing, defining health observatory survey and study protocols, apportioning duties among valid research centers, training interviewers not affiliated with health system, maintaining of experienced Iranian and international legal observers, assessing performance method of each survey, and implementing the results and findings in the future.

Background: The changes before and after fluid resuscitation in patients with septic shock and their relationship with prognosis have rarely been reported. Objectives: We aimed to observe the correlation between pulmonary vascular permeability index (PVPI), shock index (SI), and severity of septic shock. Methods: This case-control study retrospectively analyzed the clinical data of 154 patients with septic shock treated at our hospital (Weifang, China) from October 2016 to October 2018. They were divided into a survival group or a death group according to the 28-day prognosis. Univariate analysis was performed for vital signs, the acute physiology and chronic health evaluation II (APACHE-II) score, the sequential organ failure assessment (SOFA) score at admission, SI at admission (SI1), SI at 3 h after fluid resuscitation (SI2), PVPI at admission (PVPI1), PVPI at 3 h after fluid resuscitation (PVPI2), and lactate clearance rate (LCR). The correlations of PVPI and SI with the APACHE-II score, SOFA score, and LCR were analyzed by plotting the receiver operating characteristic curves. Results: Among the 154 cases, 70 survived after 28 days and 84 died. We observed that SI1, SI2, PVPI1, PVPI2, APACHE-II score, and SOFA score were significantly lower in the survival group than in the death group, while LCR was significantly higher (P < 0. 05). Also, SI1, SI2, PVPI1, and PVPI2 were positively correlated with APSCHE-II and SOFA scores of patients with septic shock, but negatively correlated with LCR (P < 0. 05). Moreover, SI2 predicted the prognosis of patients with septic shock significantly better than SI1, PVPI1, and PVPI2 did. When SI2 was 1. 22, the Youden index was 0. 822, the sensitivity was 91. 23%, the specificity was 89. 47%, the positive predictive value was 0. 912, and the negative predictive value was 0. 924. The positive and negative likelihood ratios were 0. 897 and 0. 375, respectively. Conclusions: Based on the study, SI after fluid resuscitation was more valuable for evaluating the prognosis of patients with septic shock than SI at admission, as well as PVPI values at admission and after fluid resuscitation.

Background: The major function of the bone in the skeletal system is to provide structural support to the body and its vital organs. Many patients suffer from the disability to restore bone lesions following bone fractures during crashes or accidents. The use of mesenchymal stem cells such as adipose-derived mesenchymal stem cells (ADMSCs), along with collagen scaffolds, and its transfer to the lesion site can be valued as one of the available treatment options. Objectives: In the current paper, a study was conducted on the level of mesenchymal stem cell repair from the rat adipocytes, where it was evaluated in bone defects. Methods: In this study, mesenchymal stem cells were isolated from the rat adipocytes and their stem cell lines were determined with the standard cell tests. The isolated cells were differentiated in the next step and transferred to the two main groups: nicotine modeled and non-modeled (non-nicotine) along with collagens. The repair of the defect caused by a 2 mm drill in the diaphyseal region of the rat bone was evaluated after four weeks using radiographic examination and histopathologic staining. Results: Radiographic data analysis indicated that bone density was much higher in the non-nicotine group than in the nicotine group. Histopathologic staining showed that bone formation was higher in the non-nicotine group than in the nicotine group. The new bone formation was about 80% and 60% in the non-nicotine and nicotine groups with differentiated osteocytes of ADMSCs, respectively. Conclusions: Adipose-derived mesenchymal stem cell transplantation is effective in bone defect repair and nicotine plays an important role in the bone repair process as an inhibitory agent.

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is an uncommon systemic allergic reaction, which usually occurs due to a specific medication. The mostcommonpresentation is fever, skin eruption, and lymphadenopathy that presents two to eight weeks after exposure to the culprit drug. In some cases, evidence of internal organ involvement including renal failure, respiratory symptoms, or liver involvement may present. These symptoms may present weeks to months after the exposure or even discontinuing the drug, which makes the diagnosis challenging. This report presents a young man with first presentation of icter and elevated liver enzymes, whose laboratory and imaging studies failed to diagnose the disease. A liver biopsy was performed and the pathologist reported hepatocellular carcinoma (HCC). A high level of serum alpha-fetoprotein was consistent with the histologic findings, but concerning the uncommon clinical setting, the pathologic specimen was reviewed by another pathologist, which reported hepatocyte regeneration following hepatitis. This finding was consistent with elevated serum alpha-fetoprotein. A retrospective review revealed the history of using ceftriaxone nine months before the presentation and his final diagnosis was the DRESS syndrome with a dramatic response to corticosteroid treatment.

Introduction: Coronavirus disease 2019 (COVID-19) is a novel coronavirus that was extracted from patients with respiratory tract infections. The most common symptoms of patients are fever and respiratory tract involvement. In this report, we describe one patient with frequent seizures probably due to COVID-19 infection for the first time. Case Presentation: A 30-year-old previously healthy female was admitted with generalized tonic-clonic seizure in the neurology emergency room. The patient complained of dry cough five days before the admission. She had seizures (five times) approximately every 8 hours. Brain MRI was normal and chest CT revealed focal ground-glass opacities. The respiratory specimen was positive for COVID-19 using real-time PCR assay. The symptoms of the patient improved with anticonvulsive and antiviral medications. Conclusions: To the best of our knowledge, this is the first case study to report an association between frequent seizures and COVID-19. In our opinion, there is a hypothesis about this subject that the etiology of seizure may be due to encephalitis and invasion virus to the brain or toxic effect of inflammatory cytokines.

Background: Under difficult conditions, the military need high-energy macronutrients and micronutrients during intense physical activities in order to achieve optimal fitness levels. Objectives: This randomized controlled trial aimed to assess the effects of a designed compact food bar (CFB) on the maximal oxygen uptake (VO2Max) and physical fitness in military athletes. Methods: This randomized controlled trial was conducted on 50 athletes aged 20-50 years, who were assigned into two experimental and control groups. The subjects in the compact food bar (CFB) received three packs of CFB (700 kcal each), containing functional compounds (e. g., caffeine and L-arginine), every day for 10 days. The control group consumed the regular food used in military training courses with the same daily calorie count for the same period. The exercise performance was assessed using sports tests, maximal oxygen uptake (VO2Max) as a measure of cardio-respiratory endurance in vitro, cardiopulmonary exercise tests, blood pressure, and anthropometric examinations based on the participants’ body composition and physical activity. The measurements were performed using a pedometer, and the data were recorded at baseline and after the intervention. The data was then analyzed in SPSS software version 16. Results: VO2Max and some of the exercise tests, including push-up, sit-and-reach test, and jump pair length, revealed significant increases in CFB group, compared to the control group (P < 0. 05). However, the concerned variable seemed to have no significant effects on the anthropometric indices (weight and body mass index) and body composition (lean body mass and body fat mass) in CFB group (P > 0. 05). Conclusions: According to the findings, the consumption of the proposed CFB, in comparison to regular food, could effectively improve the exercise performance in military athletes.

Background: Acute cerebral infarction (ACI) is a common cerebrovascular disease that seriously endangers human health. It is very important to carry out disease assessments to rescue patients who may suffer from preventable death. Objectives: This study aimed to explore the predictive value of concomitant disease scoring for the prognosis of patients with ACI. Methods: This is a respective observational study. A total of 399 patients with ACI from the Affiliated Hospital of North China University of Science and Technology, who met the inclusion criteria, were enrolled in the present study. The concomitant disease score was assessed within 24 hours after admission, and the risk degree of death was analyzed. Then, the goodness of fit test and validity analysis were carried out, and the best survival/death cut-off value was determined. Results: The area under the receiver operating characteristic (ROC) curve for the concomitant disease score was 0. 700, the distinctiveness was relatively good, and the prediction cut-off value was 10 points. Furthermore, the mortality rate of patients with a higher score was significantly higher compared to patients with a lower score. Conclusions: The concomitant disease score has good predictive value for the prognosis of ACI patients, and is an ideal system for evaluating the condition of cerebral infarction.