Shiraz E-Medical Journal
Year:2021 | Volume:22 | Issue:7|Papers Count:12

Context: Recently, a new coronavirus (SARS-CoV-2) as the cause of COVID-19 has made a global health crisis and a great challenge. Pregnant women and fetuses are among the high-risk groups for COVID-19. In this review, we summarize studies regarding SARS-CoV2 virus-placenta interactions at the maternal-fetal interface by demonstrating the pathogenicity of the virus and defense methods of the placenta. Evidence Acquisition: In the present study, a search was done in domestic and international databases including Google Scholar, Web of Science, PubMed, and Scopus using specifi c keywords (“ Coronavirus” OR “ COVID-19” OR “ SARS-CoV-2” ) AND (“ Fetus” OR “ Placenta” ) AND (“ Pregnancy” ), limited until August 2020. Finally, we reviewed 250 articles. Results: Generally, the pathogenicity and the life cycle of SARS-CoV-2 and virus entry and replication methods allow the virus to pass through the placenta, although there are hormonal and immune barriers in the placenta against SARS-CoV-2, such as placental type interferons. Conclusions: The SARS-CoV-2 can pass through the placenta, but there are defense methods against it.

Background: In the initial coronavirus disease 2019 (COVID-19) vaccination program, prioritizing population groups is inevitable due to limited supply. Currently, most of the allocation strategies are focused on individuals’ characteristics. Objectives: The present study aimed to assess the opinions of Iranian population in specifying high-priority individuals and groups for COVID-19 vaccination. Methods: An online survey was conducted using some popular social media in Iran. The data was collected from Iranian population (878 individuals) aged 18 years and older during the COVID-19 pandemic (2-20 May 2020) to investigate their opinions towards vaccine allocation strategies at the family and society levels. In vaccine prioritizing within family three option and in vaccine prioritizing within society, seven population groups were introduced by the respondents in a random order, respectively. To analyze the data, mean rank and univariate analysis was used. Results: Healthcare workers, high-risk patients, and the elderly were the fi rst priority groups for a vaccination with a mean rank of 2. 8, 2. 8, and 3. 8, respectively. The least priority group was policymakers and executive managers (mean rank = 5. 75). At the family level, 64% of the respondents introduced one of the family members as the fi rst priority for vaccination, followed by their children (29%) and themselves (7%). No signifi cant relationship was observed between respondents’ characteristics and their prioritization in vaccine prioritizing within society. Conclusions: Although involving public preference in decision-making is a key factor for the success of policies, careful design and implementation of vaccination programs through considering risk-benefi t assessment is strongly recommended.

Background: Cardiac troponin I (CTnI) is recognized as a proper marker for early detection of cardiac damage. Generalized tonicclonic (GTC) seizures may lead to cardiac ischemia or myocardial injury associated with elevated CTnI. The present study aimed at evaluating the level of CTnI in children with status GTC seizures. Methods: 50 patients with GTC seizures and a normal cardiac function referred to Amirkabir Hospital, Arak, Iran were evaluated. The medical history of all patients was taken, and clinical examinations were performed. For all patients were performed Serum CTnI measurements, electroencephalography (EEG), electrocardiography (ECG), and echocardiography. Results: The patients’ mean age was 7. 80  4. 01 years and 26 (52%) children were female (female: male ratio, 1. 08). the mean duration of seizure was 31. 54  1. 56 minutes. Abnormal EEG patterns were documented in 83 (86%) patients, while abnormal CT scan was not found in any of the patients. The mean level of CTnI was at the high end of the range in patients (57. 02  10. 80 ng/mL). There was a positive correlation between serum CTnI and age (P = 0. 001, R = 0. 492). Also, the serum level of CTnI was signifi cantly correlated with the onset of GTC seizure (R = 0. 004, P = 0. 001). Conclusion: The serum CTnI level exceeded the normal level in children with seizures. Therefore, cardiac monitoring of patients with status GTC seizures may be helpful in the ictal and postictal phases for evaluating cardiac injury, especially in children with risk factors for coronary diseases, such as Kawasaki disease, cardiomyopathy, or coronary anomalies.

Context: Subcellular organelles communicate with each other via their metabolites and maintain diff erent cellular functions. They contain nucleus, mitochondria, endoplasmic reticulum, peroxisomes, and lysosomes. Objectives: This study aimed to identify interorganelle communication (crosstalk) in physiopathological states of cells in health and disease. Methods: The databases including PubMed Central, Embase, Scopus, and Google Scholar were searched to extract data. For statistical analyses, percentage, relative risk, and odds ratio were used. Moreover, the risk of bias was assessed by Cochrane collaboration’ s tool. Results: Out of 20 studies included in this research, 12 (60%) studies included mitochondria-endoplasmic reticulum communication, 4 (20%) studies mitochondria-lysosome communication, 2 (10%) studies mitochondria-peroxisome, and 2 (10%) studies mitochondria-nucleus. Interorganelle crosstalk between mitochondria and peroxisome or lysosome had risk and odds of 1. 5 (effect) on aging and age-related disorders. There were no eff ects of mitochondrial communication with other organelles on certain pathologies. The relative risk of mitochondria to nucleus crosstalk on apoptosis was assessed 1. 13, and relative risk of mitochondria to lysosome crosstalk was assessed 2. In addition, the odds ratio of mitochondria to lysosome crosstalk on apoptosis was assessed 5, indicating a large eff ect on this crosstalk. Conclusions: Recent expansion of pharmacological, molecular, and genetic tools indicated these organelles have active intracellular and extracellular communications, which is important for cells and organ homeostasis. Disruption of such communication has been associated with aging and age-related disorders in this research.

Background: The health system reform plan (HSRP) was launched in Iran on 15 May 2014, with three approaches to protect people from the fi nancial system, create equity in access to health services, and improve the quality of services. Objectives: The present study aimed at investigating the changes in the rate of some rare neonatal outcomes after the implementation of HSRP in Iran. Methods: The present cross-sectional study was conducted in Izadi Hospital in Qom Province, in which 52, 817 vaginal delivery and cesarean sections were evaluated for the incidence of complications from 15 June 2011 to 15 April 2017. The complications included hypoxic-ischemic encephalopathy, low Apgar score, cephalohematoma, clavicle fracture, the Erb palsy, and intracerebral hemorrhage. Complications were compared per 10, 000 births before and after the implementation of the plan. Data were analyzed with SPSS software using t-and chi-squared tests. Results: There was a signifi cant increase after the implementation of HSRP compared to before that in the rate of complications per 10, 000 vaginal deliveries for stage 2 hypoxic-ischemic encephalopathy (P = 0. 001), birth with a low Apgar score (P < 0. 001), cephalohematoma (P < 0. 001), and clavicle fracture (P = 0. 002). In the case of cesarean section, there was a signifi cant increase in the 2 (P = 0. 001) and 3 (P = 0. 034) stages of hypoxic-ischemic encephalopathy and birth with a low Apgar score (P < 0. 001). Conclusions: It can be concluded that HSRP could somewhat achieve its goals on the promotion of vaginal delivery. However, the implementation of the plan was associated with an increase in some minor neonatal complications.

Background: Bipolar disorder is a chronic and debilitating psychiatric condition. Mobile-based psychoeducation is a very important tool for the treatment of this disorder. Objectives: The study aimed to provide scientifi c evidence regarding the eff ectiveness of these tools for patients with bipolar disorder. Methods: In a randomized control trial (RCT) with a sample size of 41, the participants were randomly assigned to one of the intervention or the control arms based on the random number table. The study was performed in a psychiatric teaching hospital in Mashhad, Iran. The primary targets of the study was to measure the depression, manic, and anxiety symptoms that were measured at baseline and 3 months follow-up for the intervention and the control group. A mobile application was developed and provided to the intervention group after discharge from the case hospital. The control group did not receive the application and received routine health care services during the study. A baseline comparison was performed between the groups, comparisons of the primary outcomes between the groups and within each group were carried out. Results: The results showed that the score of anxiety, depression, and mania at baseline and after the follow-up did not have a signifi cant decrease within the groups. In addition, a slight reduction in the depression and anxiety scores within the groups was found. The mean of anxiety (P-value: 0. 035), depression (P-value: 0. 024), and mania (P-value: 0. 007) after 3 month follow-up had a signifi cant decrease between the groups. A baseline comparison was performed between the groups, and comparisons of the primary outcomes between the groups and within each group were carried out. Conclusions: Given the low eff ectiveness of using mobile-based psychoeducation on anxiety, depression, and mania in bipolar patients. It is recommended to use mobile applications as a complementary treatment along with other types of treatment for bipolar patients in future studies to obtain more evidence about the eff ectiveness of mobile-based psychoeducation.

Background: Studies conducted in recent years have proposed a protective eff ect of vitamin D3 (VitD3) against various types of cancers. Thus, in this research, we investigated the serum levels of VitD3and its relation with prognostic clinical factors in chronic lymphocytic leukemia (CLL). Method: In this cross-sectional study, 86 CLL patients were investigated for a one-year period and evaluated for the relationship between Vit D3serum levels, Rai stages, age, gender, and pathological factors. A control group was added to the study in order to compare the VitD3 levels of CLL patients with that of the normal population. Results: The mean serum VitD3level in CLL patients was 29. 76 18. 75 ng/ml, and most of the patients were in stage I and II. There was no signifi cant association between age, sex, and Rai stages of CLL with VitD3 level. Except for splenomegaly (P < 0. 001), the leukemiarelated phenotypes, complications, and prognostic factors had no meaningful association with VitD3 (P > 0. 05) level. VitD3 serum level was meaningfully diff erent between case and control groups (P < 0. 001). Conclusion: In the current research, there was no signifi cant relationship between VitD3serum levels and investigated variables, except splenomegaly; these fi ndings are in concordance with other studies.

Dear Editor: One of the core principles in research, which must be observed by professors and students, is academic honesty in the publication and release of research results. Because of their particular nature, qualitative studies are especially susceptible to researcher’ s failure to adhere to the codes of ethics and republication of research results in diff erent papers, a phenomenon named salami publication (1, 2) or data salami slicing (3). Even though salami publication is acceptable for certain quantitative studies (1, 4), it is repeatedly occurring in the qualitative fi eld, too...

Background: Malaria is one of the most serious parasitic diseases and the major health issue in tropical and subtropical countries. Objectives: This study aimed to investigate the type of infection of female Anopheles mosquitoes to sporozoites of Plasmodium species (Plasmodium vivax and Plasmodium falciparum), using nested polymerase chain reaction (PCR) in southeastern Iran. Methods: To determine the infections and Plasmodium species using the nested PCR in Sistan and Baluchestan Province (southeastern Iran), 360 female Anopheles mosquitoes were collected from the control villages of Chabahar and Konarak counties and examined by entomology check stations affi liated with Zahedan University of Medical Sciences in the second half of 2018. The mosquitos were caught manually from indoor places (humans and animals) as well as natural and artifi cial sites, i. e., pit-shelters. After DNA extraction, the molecular analysis was performed by nested PCR. Results: Of 200 species collected from Daregas, Owraki, and Bahu Kalat in Chabahar, four Anopheles stephensi (2%) were infected with P. vivax, and of 160 samples collected from the rural districts of Konarak, including Zarabad, Heyan, Islamabad, and Joholu, two An. stephensi (1. 25%) were infected with P. falciparum. In this study, no mixed infection of Plasmodium vivax and Plasmodium falciparum were observed. Conclusions: The present study showed that the only species infected with Plasmodium in the aforementioned regions was An. stephensi, which was the most frequent species of Anopheles among other species as well. The nested PCR could be the most suitable method for detecting Plasmodium parasites in malaria vectors, among other diagnostic methods.

Background: General practitioners (GP) are the keystones in the process of referring patients in Iran. To refer patients to rehabilitation experts eff ectively and accurately, GPs need to be equipped with knowledge and understanding of physical medicine and rehabilitation (PMR) and its roles and have a positive attitude toward collaborating with rehabilitation teams. Objectives: The current study aimed at evaluating the knowledge, attitude, and practice (KAP) of GPs in Shiraz, Iran, toward the rehabilitation fi eld and teamwork. Methods: The current cross sectional study assessed the KAP of GPs working in public and private health sectors in Shiraz, Iran, in 2018 via a researcher-made questionnaire. Participants were recruited using the stratifi ed random sampling method. Results: A total of 200 GPs completed the study. The mean score of knowledge was 13. 54 2. 68 (ranging from 0 to 24), and the mean score of attitude 10. 84  2. 47 (ranging from 0 to 20). Regarding practice, none of the participants (0%) had a monthly average of more than fi ve referrals to a physiatrist. Thirty-eight (19%) respondents were interested in choosing PMR as a specialty. Conclusions: According to the current study fi ndings, GPs in Shiraz, Iran, are not equipped with adequate knowledge of rehabilitation and have a moderate attitude toward collaborating with a rehabilitation team. GPs rarely use PMR consultations for their patients’ complications. Policymakers should advocate for a higher level of collaboration between GPs and rehabilitation teams and fi nd ways to better familiarize healthcare providers with PMR.

Dear Editor: Lamotrigine is used for the treatment of seizure and bipolar depression (1). Lamotrigine prevents the opening of voltage-gated sodium channels and weakens the excitatory neurotransmitters’ release. Lamotrigine overdose can delay inter-ventricular conduction. It can culminate in the prolongation of QRS, QTc (QT corrected), and R waves (2). Data regarding lamotrigine overdose is scarce. Here, we describe a case with lamotrigine overdose, who developed Accelerated Idioventricular Rhythm (AIVR). AIVR is characterized by three or more sequential monophasic beats. AIVR has a gradual onset and a slow end (1, 2). This condition has been reported with some drugs (halothane, desfl urane, cocaine, propofol), electrolyte disturbances (hypokalemia and hyperkalemia), and cardiomyopathies, as well as after the resuscitation period (3)...

Devastating new broke out on May 21, 2021 that Dr Dinesh Mohan, one of the most noted scholars in the fi eld of road safety in the world had died from aftermath complications of COVID-19. The scientifi c community recognize Dinesh Mohan with fondness as a scholar who devoted his life to advocate traffi c safety around the world. Countless contributions in the form of more than 500 scientifi c articles, hundreds of keynote speeches and technical workshops around the world are part of his legacy, in addition to mentoring many great scientists that are actively work in the public safety. Dinesh Mohan will be remembered as a scholar who brought a new horizon in traffi c safety as a “ human right” and actively promoted this through his works around the world. Considering the origins of his education and career, that laid within the US traffi c safety institutions, he came a long way to be one of the leaders of the campaigns demanding safe and sustainable modes of transport for everyone. The story of how he left his career at IIHS (Insurance Institute for Highway Safety) in 1970s, that at the time was the leader institute in road traffi c safety in the world and partially made him the man we know, to go back to India to build a career in his own country, is the story to be told for many years. Besides his accomplishments as a scientist, his biggest contribution to the fi eld of public safety, was his vision to work with politicians to make changes. As we had the opportunity to have him helped with “ National Road Safety Enhancement Action Plan” in Iran, we had hours of discussions with him about his views on how the safety is a governmental responsibility and how the scientifi c body needs to work with the governmental agencies for public interests. The scientifi c community in Iran had known him for quite some time through his work on the national transportation plans in India, that got him involved with the Annual International Conference on Traffi c and Transportation Engineering that was held by the City of Tehran. But it was when he contributed to the International Conference on Reducing Burden of Traffi c Accidents, that we got to Devastating new broke out on May 21, 2021 that Dr Dinesh Mohan, one of the most noted scholars in the fi eld of road safety in the world had died from aftermath complications of COVID-19. The scientifi c community recognize Dinesh Mohan with fondness as a scholar who devoted his life to advocate traffi c safety around the world. Countless contributions in the form of more than 500 scientifi c articles, hundreds of keynote speeches and technical workshops around the world are part of his legacy, in addition to mentoring many great scientists that are actively work in the public safety. Dinesh Mohan will be remembered as a scholar who brought a new horizon in traffi c safety as a “ human right” and actively promoted this through his works around the world. Considering the origins of his education and career, that laid within the US traffi c safety institutions, he came a long way to be one of the leaders of the campaigns demanding safe and sustainable modes of transport for everyone. The story of how he left his career at IIHS (Insurance Institute for Highway Safety) in 1970s, that at the time was the leader institute in road traffi c safety in the world and partially made him the man we know, to go back to India to build a career in his own country, is the story to be told for many years. Besides his accomplishments as a scientist, his biggest contribution to the fi eld of public safety, was his vision to work with politicians to make changes. As we had the opportunity to have him helped with “ National Road Safety Enhancement Action Plan” in Iran, we had hours of discussions with him about his views on how the safety is a governmental responsibility and how the scientifi c body needs to work with the governmental agencies for public interests. The scientifi c community in Iran had known him for quite some time through his work on the national transportation plans in India, that got him involved with the Annual International Conference on Traffi c and Transportation Engineering that was held by the City of Tehran. But it was when he contributed to the International Conference on Reducing Burden of Traffi c Accidents, that we got to know his best. This conference was held for 10 years during the decade of action by the Health Policy Research Center of the Shiraz University of Medical Sciences and Dinesh Mohan was an Important part of this program with his contributions as keynote speaker and workshop lecturer. In addition to his wisdom, he brought a lot of joy to our annual meetings with his passion for spreading the knowledge, his unique examples and sense of humor. We were also fortunate to have Dinesh Mohan’ s vision as one of the advisers during the development of the “ National Road Safety Enhancement Action Plan” in Iran. During long discussion sessions we got to hear his views on how the safety is a governmental responsibility and how the scientifi c body needs to work with the government agencies for public interests. Dinesh Mohan was an exceptional humanitarian; he dedicated his life to serve his fellow human beings, he fought for the safety of everyone regardless of their origins, he did many notable works in developing countries, and he humbly never looked at his work on public safety as a business. His recent work to establish a non-profi t organization to provide independent authoritative advice on global road safety policies by road safety scientists that have no fi nancial confl icts of interest and extensive background to work in Eastern Mediterranean Region, in many troubled countries, clearly parades his principles. Throughout his life, Dinesh Mohan has represented academia at its best; “ a competent scholar, a visionary thinker, and an exceptional human being” , that made him an icon for scientifi c communities. He will be remembered with his depth of knowledge, his bold language, his strength, and his love for fellow human beings. Now, all we are left with is fond memories of a great man, an example to look at, and a path to follow. Dinesh Mohan will be dearly missed forever.