Multiple Myeloma in a Patient With Familial Mediterranean Fever

Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent episodes of painful inflammation in the abdomen, chest, or joints. The coexistence of multiple myeloma (MM) and FMF is an extremely rare event. Here, we report a case of FMF with concurrent MM. A 63-year-old woman was diagnosed with FMF since 15 years earlier. She was admitted with a complaint of low back pain. Regarding the presence of back pain, anemia, hypercalcemia, and kidney failure, a diagnosis of MM was suspected. A skeletal survey showed punched-out lesions in the skull. Serum protein electrophoresis demonstrated an immunoglobulin G kappa monoclonal gammopathy, and bone marrow aspiration revealed 30% involvement by abnormally appearing plasma cells, suggestive of MM. Although the association between FMF and MM may be a mere coincidence, further studies are necessary to understand their concurrent development

Seizure, Deafness, and Renal Failure: A Case of Barakat Syndrome

Etiologic diagnosis of seizure requires proper consideration of apparently unrelated clinical features of the patient. Here, we report the case of a patient of status epilepticus with moderate-to-severe bilateral sensorineural deafness. Investigations showed extensive intracranial calcification, hypoparathyroidism and unilateral renal agenesis. The features were consistent with Barakat syndrome, a rare developmental disorder associated with mutations in the GATA3 gene. To the best of our knowledge, this is the first reported case of Barakat syndrome from India

Soil Contamination of Public Places with Toxocara spp. Egg in Kermanshah, Iran, in 2014

Background: Toxocariasis is considered as an important neglected tropical disease. Although, the prevalence of Toxocara eggs in soil has previously been reported in different parts of Iran, the extent of this condition is not precisely known in Kermanshah city, west of Iran.Materials and Methods: A total of 126 soil samples were collected from different zones of Kermanshah public places during April-June 2014. The samples were examined for Toxocara spp. eggs via modified floatation method using sodium nitrate (NaNO3) and the data was analyzed using Data Analysis and Statistical Software (STATA Ver.13.1).Results: Toxocara spp. eggs were found in 17 (13.5%) out of 126 samples collected from the studied areas. There was a significant difference between contamination rate in the areas with low levels of health status and that in the areas with high levels (p=0.003).Conclusion: According to the results obtained in the present study public parks, streets, and squares of Kermanshah are contaminated with eggs of Toxocara spp. Considering these findings, establishment of a wisely planned health program for controlling helminthes in the soil and the population of the stray dogs and cats in order to reduce the distribution of parasitosis is strongly recommended

Applying the health belief model and behavior of diabetic patients: A systematic review and meta-analysis

The patient’s belief and knowledge about his or herillness is the most important factor of disease control;the aim of present study is to perform a systematicreview-based meta-analysis of health belief and itsdimension’s mean score in diabetic patients.The present systematic review and meta-analysis wasconducted in 2020. Data were gathered by searchingthe Google Scholar, Scopus, PubMed, Web of Science,and Science Direct databases from 2010 to 2020. Keywords were “health belief”, “HBM”, “diabetic patients”,“diabetes mellitus”. To estimate the pooledscore of health belief and its dimensions, the randomeffectsmeta-analysis was performed using STATA 15.The presence of heterogeneity across the studies wasassessed with the I2 statistic. A forest plot was usedto report the results.The mean health belief obtained from the two methods,fixed (3.422, 95% CI: 3.128–3.716) and random(3.422, 95% CI: 3.128–3.716) what are the same, is thesame. The strongest dimension is “perceived benefits”with an mean (3.8) and the weakest dimension is “perceivedsensitivity” with an mean (3.0).Conclusions. Policymakers and decision makers in thefield of hygiene and controlling non-communicablediseases should focus on the role of patients’ awarenessof their disease and try to improve it. In the meantime,the dimension of “perceived sensitivity” needs more attention.Strategies such as holding training classes andusing technological infrastructure to promote this conceptshould be used

Social distance capacity to control the COVID-19 pandemic: A systematic review on time series analysis

Abstract. BACKGROUND: Reducing interpersonal contact has been one of the least expensive and most widely used COVID-19 control strategies. OBJECTIVE: This systematic review has been conducted with the aim of identifying social distancing strategies and policies and their impact on the COVID-19 pandemic. METHODS: In order to compile this systematic review, Google Scholar, PubMed, Scopus, Web of Science, Science Direct, Magiran, SID, and Irandoc databases were searched from the COVID-19 outbreak until March 2021. Keywords included “social”, “physical”, “distance”, “outbreak”, “incidence”, “prevalence”, “spread”, “new case”, “death*”, “mortality*”, “morbidity*” , “covid-19”, “coronavirus”, “sars-cov-2” and “time series*”. The articles were qualitatively evaluated by two researchers using the STROBE tool. Finally, the study data were divided into three conceptual categories by three researchers, who then agreed on one category. The practical suggestions were also categorized in the same way. RESULTS: The policies and strategies adopted to implement social distancing were included in five categories of restrictions, prohibitions, closures, incentives, and punishments. Transportation and travel restrictions, crowded places and schools closure, use of telecommunications and virtual communications, and financial and psychological support to society members were the main policies in this area. CONCLUSION: Rapid and complete vaccination of all people around the world is out of reach, therefore social distancing and the implementation of physical restraints, especially in crowded and densely populated environments, should be done extensively until COVID-19 is eradicated. Keywords: Social distance, new cases, death, COVID-19, coronavirus, time series, healt

Understanding Medication-Related Belief in Patients with Type 2 Diabetes: a Meta-Analytic Review

ABSTRACT Background: The medication belief and appropriate and on-time medication usage are crucial determinants of diabetes control. The present systematic review has been conducted to examine the status of the medication beliefs of patients with type 2 diabetes based on a meta-analysis. Materials and methods: This study is a systematic review based on a meta-analysis conducted in 2021. Keywords “Medication belief”, “BMQ (Belief in Medication Questionnaire)”, “patients with type 2 diabetes”, “diabetes mellitus” were searched in Google Scholar, PubMed, Scopus, Web of Science, Science direct, Magiran, SID, and Irandoc database from 2010 to 2021. The pooled score of medication belief and its dimensions were estimated through a random-effects meta- -analysis using STATA 15. Also, heterogeneity across the articles was determined with the I2 statistic. Results: Out of 584 articles, 8 studies were selected and analyzed. Based on estimates obtained from the random effects method, the pooled score of medication belief was obtained at 2.877 (95% CI: 2.22–3.53). Also, the pooled scores of specific necessity, specific concern, general harm and general overuse were calculated at 3.60 (95% CI: 2.92–4.06), 3.02 (95% CI: 2.19–3.85), 2.26 (95% CI: 1.50–3.02) and 2.54 (95% CI: 1.96–3.12) respectively. Conclusions: Health policymakers and economists need to take steps to increase the health literacy of patients with type 2 diabetes and improve the medication belief dimensions to reduce the disease costs to provide a better quality of life for patients with type 2 diabetes. Various programs are underway in developed countries. Public education about the side effects of diabetes drugs, narcotics, and drug dependence reduces patients’ worries and anxieties, which in turn reduces their anxious thoughts and brings relief to patients. (Clin Diabetol 2022, 11; 3: 200–209) Keywords: medication belief model, patients with type 2 diabetes, BMQ, systematic review, metaanalysi

Subtype distribution of Blastocystis sp. isolated from humans in Iran: a systematic review and meta-analysis

Aim: This systematic review and meta-analysis evaluated the subtyped Blastocystis sp. isolated from humans in Iran. Background: Blastocystis sp. is an anaerobic intestinal protozoan that infects humans as well as domestic and wild animals, i.e. mammals, amphibians, reptiles, and arthropods. Methods: A comprehensive search for papers published before April 2022 was undertaken utilizing English and Persian databases. The following MeSH keywords were used in the electronic search: (Blastocystis sp.) AND (molecular OR subtype) AND (prevalence OR epidemiology) AND Iran. The quality of the included studies was evaluated. Thereafter, a random-effects meta-analysis was conducted to estimate the pooled prevalence and odds ratios regarding the included studies. Results: A total of 32 studies comprised of five case-control studies and 27 cross-sectional studies met the eligibility criteria. The overall pooled prevalence of subtyped Blastocystis sp. in Iran was estimated to be 10% (95% confidence interval: 6 to 15%). Eight subtypes of Blastocystis sp. (ST1- ST7 and ST9) were identified in our study, of which ST3 was the most common subtype (0.04); 0.02-0.07). The difference in subtypes between two case and control groups in reported studies was not significant, but the odds ratio of infection by ST3 (0.98; 95% CI, 0.30 to 3.20) was higher in cases. Conclusion: The current systematic review showed that with the exception of ST8 and ST12, all human Blastocystis sp. subtypes reported in the world are found in different parts of Iran

Developing decision model for the outsourcing of medical service delivery in the public hospitals

Abstract Background: The decision to outsource an activity is one of the most complex organizational decisions. This decision is also infuenced by several factors and components. In order to facilitate and optimize it, for the frst time in this study, a decision model for outsourcing medical service delivery in public hospitals has been developed. Methods: We conducted this cross-sectional study in 3 stages: 1) We identifed the factors afecting the outsourcing decisions, 2) an expert panel identifed the infuential factors. After standardization, we distributed 220 questionnaires among university staf managers and heads, nursing managers, and managers of the research units, and 3) Structural Equation Model applied to evaluate the relationship between the variables on AMOS22, at 0.05 signifcant level. Results: Findings indicated the optimal level of all ft indices. The path coefcient between all identifed factors with the outsourcing decision was positive (t>1.96). Factors ranging from the most efective to least efective included monitoring and control, service type, human resource, economic and fnancial, executive capability, external environment, and terms and conditions. Conclusion: The proposed model provides unit evaluation to make the appropriate decision on outsourcing or non-outsourcing. Control and monitoring were the most determining factors. We recommend performing monitoring continuously as a guide and deterrent to error. We also recommend continuous monitoring and control over the quality of outsourced units and stakeholder satisfaction. Keywords: Outsourcing, Hospital, Medical service, Decision mode

Coagulopathy: Another side effect of coronavirus infection

Recently, coronavirus disease 2019 (COVID-19) has been considered as a major health problem around the globe. This severe acute respiratory syndrome has a bunch of features, such as high transmission rate, which are adding to its importance. Overcoming this disease relies on a complete understanding of the viral structure, receptors, at-risk cells or tissues, and pathogenesis. Currently, researches have shown that besides the lack of a proper anti-viral therapeutic method, complications provided by this virus are also standing in the way of decreasing its mortality rate. One of these complications is believed to be a hematologic manifestation. Commonly, three kinds of coagulopathies are detected in COVID-19 patients: disseminated intravascular coagulation (DIC), pulmonary embolism (PE), and deep vein thrombosis (DVT). In this paper, we have reviewed the relation between these conditions and coronavirus-related diseases pathogenesis, severity, and mortality rate