The effect of Coronavirus disease pandemic on maternal and neonatal health: A cohort study from Isfahan, Iran

Background: The Coronavirus disease-2019 (COVID-19) pandemic may profoundly impact on maternal and neonatal health worldwide. However, a few studies have investigated this topic. Objective: This study aimed to investigate the impact of the COVID-19 pandemic on maternal and neonatal health. Materials and Methods: This retrospective cohort study analyzed collected data from March to May 2020, and the same period in 2019, involving 5711 pregnant women referring to comprehensive healthcare centers in Isfahan province health facilities, Iran. Pregnant women and neonates were followed-up until 40 days after the delivery. Demographic characteristics, pre-pregnancy, antenatal care, and postpregnancy variables were collected. Results: A total of 5,711 pregnant women were studied, of whom 3477 (61%) were referred in 2019 (before the COVID-19 pandemic as nonexposed) and 2234 (39%) during the COVID-19 pandemic (as exposed group) in 2020. For those living in cities with a population of > 20,000, the number of antenatal care were lower about 2% compared to nonexposed group (p = 0.01). The number of mothers with a history of the underlying disease who referred to a comprehensive healthcare center during the COVID-19 pandemic (47%) was lower about 6% compared to nonexposed group (41%) (p < 0.001). During the COVID-19 pandemic, the prevalence of hypertension and gestational diabetes mellitus was 5% (n = 109) and 20% (n = 445), which were higher about 2% and 4%, respectively, compared to nonexposed group. The COVID-19 pandemic had no other significant effect on mothers’ and neonates’ other characteristics than nonexposed group. Conclusion: The COVID-19 pandemic imposes no significant effect on mothers’ and neonates’ health compared to nonexposed group. Key words: Maternal health, Neonatal health, Pregnancy, COVID-19

A randomized field trial for the primary prevention of osteoporosis among adolescent females: Comparison of two methods, mother centered and daughter centered

Background: Osteoporosis is a serious public health. Since the majority of bone mass occurs during adolescence, primary prevention is important. Probably mother's participation in health education interventions leads to promote health behaviors in children. Aims: To assess a lifestyle modification intervention focused on mothers and students has an impact on osteoporosis preventive behaviors in adolescent girls. Materials and Methods: It is a randomized field trial in female high schools. 210 girls aged between 11 and 15 were randomly selected. Students in groups A and C and mothers in group B were selected Through the sampling frame. Our lifestyle modification was based on group based education in the public girls' high schools. Subjects in the intervention groups participated in three educational sessions. Students' osteoporosis preventive behaviors were measured by using a lifestyle questionnaire consisting of items assessing nutrition, physical activity and sun exposure. Repeated measure ANOVA at baseline, 4 week, 2 months and 6 months and were used to analyze the data. Results: After 1 month, diet and sun exposure scores increased significantly (P < 0.001) but it was higher in group B compared with group A. (About diet P < 0.001 and sun exposure = 0. 001). After 6 months, diet and sun exposure status in the group A approximately decreased to baseline, while in group B, diet components were significantly different compared to baseline (P < 0.001). There was no change in physical activity. Conclusion: Osteoporosis prevention intervention of adolescent can be effective when parents or girls participate in training sessions, but education is associated with better outcomes when focused on mothers

COVID-19-associated thrombotic thrombocytopenic purpura (TTP); a case report

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease (COVID-19) pandemic is the largest infectious crisis in the present century. It has been reported that COVID-19 infection may trigger autoimmune diseases. Herein, we report a 68-year-old male that was diagnosed with thrombotic thrombocytopenic purpura (TTP) following COVID-19 infection. To our knowledge, this is the fourth case of COVID-19-associated TTP. More attention is required regarding the possibility of developing TTP in COVID-19 patients, especially with the presence of decreased consciousness and low levels of hemoglobin and platelet

The Protective Effect of Curcumin on Hepatic Function in Cancer Patients Receiving Taxane-Based Chemotherapy: A Randomized Controlled Clinical Trial

Background: Cancer has become a significant health challenge in recent decades. The Taxane family is one of the popular chemotherapeutic agents which can cause hepatic injury. The present study was conducted with the aim of evaluating the hepatoprotective effect of Curcumin on cancer patients treated with Taxanes. Method: This controlled randomized clinical trial (RCT) has been conducted on 80 patients with either breast, ovary, or pancreas cancer randomly allocated to the intervention group (n = 37) treated with daily 47.5 mg Curcumin extract or the control group (n = 34) treated with placebo. Hepatic indices, including alanine transaminase, aspartate transaminase, total bilirubin, and alkaline phosphatase, were measured and compared at baseline within three and six weeks after the intervention initiation. Results: The assessments revealed a remarkable increase in all of the indices in both groups by the time (P < 0.05), while these increases were remarkably less among the patients treated with curcumin in comparison with placebo treatment (P < 0.05). The Mean ± standard deviation was 26.3 ± 8.6 and 29.8 ± 10.5 for aspartate transaminase, 25.5 ± 8.3 and 30.2 ± 10.6 for alanine transaminase, 122.9 ± 18.02 and 126.8 ± 16.9 for alkaline phosphatase, 0.88 ± 0.10 and 0.95 ± 0.12 for bilirubin in the intervention and control groups, respectively. Conclusion: Based on the current study's findings, Curcumin could act relatively as a hepatoprotective agent against Taxane; however, further studies are strongly recommended to determine the dosage and consumption instruction of this agent for patients with cancer

Too late relapse of testicular cancer after 27 years; a case report

Background: Germ cell tumors (GCTs) are the most common solid tumors in young men, with a peak incidence at 25-35 years. Approximately 50% of the testicular GCTs are pure seminomas and 50% are non-seminomas. Late relapse of testicular cancer (LRTC) is a rare disease with the incidence rate of 2.6% and is defined as >2 years interval between initial treatment and recurrence. Case Presentation: We report here a patient with nonseminomatous GCT who experienced relapse 27 years after his first diagnosis. He came with gross hematuria and huge abdominal mass. There was a giant retroperitoneal mass with invasion to the left kidney and other organs in computerized tomography. A biopsy was conducted and pathology revealed recurrence of malignant mixed nonseminoma GCT. The tumor was unresetable. Therefore patient was treated with four cycles of chemotherapy. PET scan was conducted after chemotherapy showed residue of tumor thus retroperitoneal lymph node dissection (RPLND) was done. Conclusions: We concluded that with increasing lifespan of cancer patients, follow up of these patients for very late relapse must be conducted lifelong

Treatment of chemotherapy induced anemia; a randomized clinical trial to compare quality of life in patients taking intravenous versus oral iron

Introduction: Malignancy is one of the causes of anemia in chronic diseases. Anemia can commonly complicate the malignancy process. Objectives: This study aimed to compare improvement in the quality of life and hemoglobin levels between cancer patients with chemotherapy-related anemia receiving erythropoietin and injectable iron supplement versus patients receiving erythropoietin and oral iron supplement. Patients and Methods: This investigation was a randomized clinical trial carried out on 79 anemic individuals with metastatic and non-metastatic carcinoma who were undergoing chemotherapy. Individuals included in the study were randomly assigned to the two groups. The first group received erythropoietin and Venofer while the second group received erythropoietin and ferrous sulfate for 6 weeks. The quality of life for patients was assessed using the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30). Results: Hemoglobin levels in both groups increased significantly while the difference between them was not significant. Despite improvement in more indexes of the questionnaire, post-treatment quality of life in both groups had no significant statistical difference (P > 0.05). The changes in indices after interventions showed no difference between the oral and injectable iron supplements groups (P > 0.05). Conclusion: The results of this study showed that administration of erythropoietin and iron supplements, either orally or intravenously, even with a shorter duration of treatment could increase hemoglobin levels in chemotherapy-induced anemia group, however to improve the quality of life, it may be necessary to employ larger sample sizes and prolong treatment courses