Effect of epidemic management and control plan on COVID-19 mortality in Iran: an interrupted time series analysis

Background: Several measures have been taken around the world to decrease  COVID-19 mortality. However, the effectiveness of preventive measures on the mortality related to COVID-19 has not been fully assessed. Thus, the aim of the present study was to evaluate the success of COVID-19 epidemic management and control plan on the mortality related to COVID-19 in Iran since February 19, 2020 to February 5, 2021. Methods: In the current quasi experimental study an interrupted time series analysis (ITS) of daily collected data on confirmed deaths of COVID-19 occurred in Iran and in the world,  were performed using Newey ordinary least squares (OLS) regression-based methods. Results: In Iran the trend of new deaths increase significantly every day until 24 November 2020 according to pre intervention slope of 1.14 (95% CI = [0.96 – 1.32]; P < 0.001). The occurrence of new deaths had a decreasing trend after 24 November 2020 with a coefficient of  -5.12 (95% CI = [-6.04 – -4.20; P <0.001]). But in the global level daily new deaths was increasing before (18.66 (95% CI = [14.41 – 2292]; P < 0.001)) and after the 24 November 2020  (57.14 (95% CI = [20.80–  93.49]; P: 0.002)). Conclusion: Iranian Covid-19 epidemic management and control plan was able to reduce the mortality related to COVID-19, effectively. Therefore, it is essential to continue these measures, in order to  prevent the increase in the number of deaths

Determine the most common clinical symptoms in COVID-19 patients: a systematic review and meta-analysis

Introduction: COVID-19 is an emerging infectious disease. The study about features of this infection could be very helpful in better knowledge about this infectious disease. The current systematic review and meta-analysis were aimed to estimate the prevalence of clinical symptoms of COVID-19 in a systematic review and meta-analysis. Methods: A systematic review using Medline/PubMed, Scopus, and Google scholar has been conducted. In the current systematic review and meta-analysis, the articles published in the period January 1, 2020, to April 2, 2020, written in English and reporting clinical symptoms of COVID-19 was reviewed. To assess, the presence of heterogeneity, the Cochran’s Q statistic, the I2 index, and the tau- squared test were used. Because of significant heterogeneity between the studies the random-effects model with 95% CI was used to calculate the pooled estimation of each symptom prevalence. Results: The most common symptoms in COVID-19 patients include: Fever 81.2% (95% CI: 77.9-84.4); Cough: 58.5% (95% CI: 54.2-62.8); Fatigue 38.5% (95% CI: 30.6-45.3); Dysp- nea: 26.1% (95% CI: 20.4-31.8); and the Sputum: 25.8% (95% CI: 21.1-30.4). Based on the meta-regression results, the sample size used in different studies did not have a significant effect on the final estimate value (P > 0.05). Conclusion: Considering the main symptoms of COVID-19 such as Fever, Cough, Fatigue, and Dyspnea can have a key role in early detection of this disease and prevent the transmission of the disease to other people

Is single point HbA1c a reliable predictor for death in severe COVID-19?

The severity of COVID-19 infection is affected by several risk factors such as Diabetes Mellitus (DM). The current study aimed to determine the effect of single-point HbA1c on the severity and mortality of hospitalized COVID-19 patients. Methods This cross-sectional study was conducted among hospitalized moderate and severe COVID-19 patients in Baharloo Hospital in Iran between   December 23rd and February 23rd, 2021. The patients have been diagnosed by Polymerase Chain Reaction (PCR) and Chest Computed Tomography (CT) imaging as COVID -19. Demographic data, clinical presentation, laboratory results, and treatments along with the HbA1C data were included. Results 165 COVID-19 cases were included in this study; 126 (76.4%) of which were severe cases. 89 (53.9%) patients were male, with a mean age of 59.89± 16.59 years. Severe COVID-19 patients were more prone to a longer hospital stay, and a higher level of inflammatory mediators, compared to the moderate COVID-19 patients (P<0.05). No significant association was found between single point HbA1C, FBS, and severity and mortality of COVID- cases (p>0.05). Conclusion  Single point HbA1c was not a reliable mediator for the prediction of severity or death in hospitalized COVID-19 patients

The effect of early tranexamic acid on bleeding, blood product consumption, mortality and length of hospital stay in trauma cases with hemorrhagic shock: a randomized clinical trial

Introduction: Because no medication has been approved for coagulation support in trauma, the current study was aimed to evaluate the effectiveness of intravenous injection of Tranexamic acid (TXA) in patients with acute traumatic bleeding. Methods:  In the current randomized controlled clinical trial, 68 patients with acute bleeding and hemorrhagic shock presentation due to blunt trauma of the abdomen, pelvis, and thorax, randomly assigned into two groups of TXA and placebo. Results :There was no statistically significant difference between the two groups in terms of Systolic blood pressure, pulse rate, Base excess, serum hemoglobin changes, bleeding volume, the incidence of thrombotic events, and the number of deaths (p>0.05). But Systolic blood pressure, pulse rate, base excess, and serum hemoglobin, changed significantly within each group over time(p<0.05). The median time for the length of hospital stay among the TXA group was lower than the Placebo group (6 days versus 10 days, p: 0.004). Also, there was a significant difference between the two groups about the median of pack cell, Platelet consumption, and bleeding Volume (p<0.05). Conclusion  The use of TXA is associated with lower use of blood production and reduced length of hospital stay, however, thrombotic events incidence and mortality rates between the TXA and placebo groups were not different

Assessment of the belief and attitudes of Iranian healthcare personnel’s toward the influenza infection and influenza vaccination

Introduction: influenza is one of the main public health problems and Health Care Personnel's is one of the at-risk groups for this infection. So regarding this point, the goal of this research was to identify the beliefs and attitudes of the HCPs (Health Care Personnel) about influenza and the influenza vaccine. Methods: This cross-sectional study was planned in a general hospital in Tehran; Iran from January to June 2016.A total of 418 questionnaires was distributed among the HCPs. The entire data set was analyzed using the SPSS. We used the Chi2 test, linear regression and one-way ANOVA for data analysis. P-values less than 0.05 were considered as statistically significant. Results: The influenza vaccination coverage was 57.7%; the highest vaccine rate belonged to the allied health professionals (68.2%). Two main causes for avoiding the influenza vaccination were; the “fear of vaccine adverse effects” and the “uncertainty about the vaccine effectiveness”. The linear regression analysis identified that the physicians had the highest belief score, followed by the nurses and the allied health professionals (p <0.001).  Conclusions: Educational planning on influenza and influenza vaccination is necessary to improve the vaccination coverage and to reduce the influenza mortality and morbidity in susceptible patient

Productivity and years of life lost due to fatal traffic injuries in Shiraz Shahid Rajaei Hospital during 2009-2013

Background: Road traffic injuries (RTIs) are an important public health concern, and one of the main causes of death leading to loss of productive and effectual years of life. This study aimed to determine the economic burden of fatal crashes for about 5 years in Shahid Rajaei Hospital in Shiraz. Methods: In this cross-sectional study, cost and demographic data related to the people who died in the hospital due to RTIs, during 2009-2013, were obtained from medical records. Economic burden of traffic accidents that led to death was estimated using human capital as direct costs of treatment and potential years of life lost (PYLL) and lost productivity as indirect costs. Results: During 2009-2013, 989 individuals died from traffic accidents in Shiraz, imposing 1.58 million US dollars to hospital costs, 41,298 PYLL, and 67 million US dollars productivity lost. In this study, the mean age of the dead people was 43.3 ± 22.24, and the productivity lost per capita was 67,000 US. Conclusions: The economic burdens of traumatic brain injuries were high in fatal accidents in Fars Province equivalent to 0.0003 of Iran's gross domestic product in 2013. Thus, special attention should be directed toward prevention measures for fatal traffic accidents

Case Fatality Rate of COVID-19: A Systematic Review and Meta-Analysis

Objective: The ongoing novel coronavirus disease 2019 (COVID-19) is the main cause of morbidity and mortality due to its contagious nature and absence of vaccine and treatment. Although there are considerable primary studies that reported extremely variable case fatality rate (CFR) of COVID-19, there is no review study that attempted to estimate CFR of COVID-19. The current systematic review and meta-analysis was aimed to estimate the pooled CFR of COVID-19. Methods: Electronic databases: PubMed, Science Direct, Scopus and Google Scholar were searched to retrieve the eligible primary studies that reported CFR of COVID-19. Keywords: ("COVID-19"OR "COVID-2019" OR "severe acute respiratory syndrome coronavirus 2"OR "severe acute respiratory syndrome coronavirus 2" OR "2019-nCoV" OR "SARS-CoV-2" OR "2019nCoV" OR (("Wuhan" AND ("coronavirus" OR "coronavirus")) AND (2019/12[PDAT] OR 2020[PDAT]))) AND ("mortality "OR "mortality" OR ("case" AND "fatality" AND "rate") OR "case fatality rate") were used as free text and MeSH term in searching process. Random-effects model used to estimate the CFR in this study. I2 statistic, Cochran’s Q test and T2 were used to assess the available heterogeneity between included studies. Results: The overall pooled CFR of COVID 19 was 10.0 %( 95% CI: 8.0-11.0); P<0.001; I2 = 99.7). The pooled CFR of COVID 19 in general population was 1.0% (95% CI: 1.0–3.0); P<0.001; I2 = 94.3), while in hospitalized patients was 13.0 % (95% CI: 9.0–17.0); P<0.001, I2 = 95.6). The pooled CFR in patients admitted in intensive care unit (ICU) was 37.0 % (95% CI: 24.0–51.0); P<0.001, I2 = 97.8) and in patients older than 50 years was 19.0 % (95% CI: 13.0–24.0); P<0.001; I2 = 99.8). Conclusion: The present review results highlighted the need of transparency in testing and reporting policies and denominators used in CFR estimation. It is also necessary reporting the cases age, sex and the comorbidity distribution of all patients which important in comparing the CFR among different segments of population

Association between parity and obesity: A cross sectional study on 6447 Iranian Females

Objective: The aim of this study was to determine the relationship between parity and obesity in Iranian women.   Methods: In a cross-sectional study, a total of 6447 urban women aged 40-65  were studied. A face-to-face interview was conducted by trained personnel. Statistical associations between parity and obesity using the multivariate logistic regression model were examined.  Results: The mean age of the enrolled women was 48.4 ± 6.1 years. The mean BMI was 27.55 ± 4.5 Kg/m2. Of the total participants enrolled, 3517 (54.6%) had <3 parities, while 2930 (54.4%) had ≥3 parities. The prevalence of obesity (BMI ≥30 Kg/m2) and overweight (30> BMI ≥25) was 27.50 % (95% CI 26.85-28.15) and 43.70% (95% CI 42.98-44.42), respectively. After adjustment for potential confounders, women with ≥3 parities were at higher risk of being obese (OR 1.19, 95% CI 1.05-1.35).  Conclusion: There was a statistically significant positive association between higher parity and obesity. According to the results of this study, Body Mass Index (BMI) is associated with high parity in Iranian women. It is recommended that health policymakers plan appropriate weight loss programs for postpartum

The Prediction Incidence of the Three Most Common Cancers Among Iranian Military Community During 2007-2019: a Time Series Analysis.

Objective. Cancers are one of the most important public health problems in Iran. Because of the importance of cancers, the purpose of the current study was to the prediction of the future incidence of the most common cancers among Iranian military community (MC) by using the time series analysis during 2007 to 2019.Methods. In the current cross-sectional study, all registered cancers among Iranian MC entered the study. To select the best model of prediction, various methods including autocorrelation function (ACF), partial autocorrelation function (PACF), and Akaike information criterion (AIC) statistics were used. All analysis was performed by using ITSM, stata14, and Excel2010 software.Results. The most prevalent cancers among Iranian MC were breast, prostate, and colon cancers respectively. The time series analysis was shown that the trend of all mentioned cancers in Iranian MC will increase in the coming years.Conclusion. the trend of most prevalent cancers among Iranian MC was increasing but the different factors like the growth of population size and improving the registration system