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

Smoking and Brain Neoplasm: An Immunohistochemical Data Evaluating Caspase-3 and MMP-2 in Rat Brain

Background and Aim: Smoking has been extensively investigated in oncology, and controversial associations with brain tumor incidence have been reported. Caspase-3 and matrix metalloproteinases (MMPs) belong to an important cascade in tumor vasculogenesis. We aim to study the smoking impact on these signaling molecules in nontumoral rat brain tissue. Methods and Materials/Patients: A total of 60 Wistar rats were divided into two groups: treatment (cigarette smoke/electronic cigarette) and control groups with subgroups of male and female rats. After general anesthesia and decapitation, their brains were collected, and 3-μm thick coronal sections were prepared. Following immunohistochemical staining with rabbit anti-MMP-2 and anti-caspase-3 antigens, protein expressions were analyzed by selecting two fields at 400x magnification. Results: Our data suggest that the expression of MMP-2 was not significantly different between the studied groups. However, the significant inductive activity of cigarette smoking was observed on caspase-3. Conclusion: Cigarette smoking indicates pro-tumoral signaling impact in normal tissue with activation of caspase-3 in rat brain tissue

Pain neuroscience education, blended exercises and booster sessions as an effective therapy for pain, functional and psychological factors in patients with knee osteoarthritis: a study protocol for a single-blind randomised controlled trial with 22 factorial design during 6-month follow-up

Introduction This study aims to investigate whether a pain neuroscience education (PNE) combined with a blended exercises programme including aerobic, resistance, neuromuscular, breathing, stretching and balance exercises and diet education provides greater pain relief and improvement in functional and psychological factors than PNE and blended exercises alone and whether ‘exercise booster sessions (EBS)’ approach may improve outcomes and increase adherence in patients with knee osteoarthritis (KOA) (by telerehabilitation (TR)).Methods and analysis In this single-blind randomised controlled trial, 129 patients (both genders; age >40) diagnosed with KOA will be randomly assigned to one of the 22 treatment combinations as: (1) blended exercises alone (36 sessions over 12 weeks), (2) PNE alone (three sessions over 2 weeks), (3) combination of PNE with blended exercises (exercise three times a week for 12 weeks combined with three sessions of PNE) and (4) a control group. Outcome assessors will be blinded towards group allocation. The primary outcome variables are the visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis index in knee osteoarthritis (WOMAC) score. Secondary outcomes include Pain Self-Efficacy Questionnaire (PSEQ), Depression, Anxiety and Stress Scale (DASS), Tampa Scale for Kinesiophobia (TSK), Short Falls Efficacy Scale International (FES-I), Pain Catastrophising Scale (PCS), Short Form Health Survey (SF-12) and Exercise Adherence Rating Scale (EARS), 30 s sit-to-stand test (30CST), Timed Up and Go (TUG), lower limbs’ muscle strength and lower limb joints’ active range of motion (AROM) will be performed at baseline, 3 and 6 months’ postinterventions. The primary and secondary outcomes will assess at baseline, 3 months and 6 months postinterventions.The findings will be useful in establishing an effective treatment strategy covering multiple aspects behind KOA. The study protocol is conducted in clinical settings, thereby enhancing the possibility of future implementation of the treatments in the healthcare systems and self-care management. Results in comparison between groups will help to clarify the most effective of mixed-method TR (blended exercise, PNE, EBS with diet education) on more improvement in pain, functional and psychological factors in patients with KOA. This study will combine some of the most critical interventions, to be able to introduce a 'gold standard therapy’ in the treatment of KOA.Ethics and dissemination The trial has been approved by the ethics committee for research involving human subjects of the Sport Sciences Research Institute of Iran (IR.SSRC.REC.1401.021). The study findings will be published in international peer-reviewed journals.Trial registration number IRCTID: IRCT20220510054814N1

The effects of prognostic factors on transplant and mortality of patients with end-stage liver disease using Markov multistate model

Background: Decompensated cirrhosis patients have a high risk of death which can be considerably reduced with liver transplantation (LT). This study aimed to simultaneously investigate the effect of some patients' characteristics on mortality among those with/without LT and also LT incident. Materials and Methods: In this historical cohort study, the information from 780 eligible patients aged 18 years or older was analyzed by the Markov multistate model; they had been listed between 2008 and 2014, needed a single organ for initial orthotopic LT, and followed at least for up to 5 years. Results: With a median survival time of 6 (5–8) years, there were 275 (35%) deaths. From 255 (33%) patients who had LT, 55 (21%) subsequently died. Factors associated with a higher risk of mortality and LT occurrence were included: higher model for end-stage liver disease (MELD) score (hazard ratio [HR] = 1.16, confidence interval [CI]: 1.09–1.24 and HR = 1.22, CI: 1.41–1.30) and ascites complication (HR = 2.34, CI: 1.74–3.16 and HR = 11.43, CI: 8.64–15.12). Older age (HR = 1.03, CI: 1.01–1.06), higher creatinine (HR = 6.87, CI: 1.45–32.56), and autoimmune disease versus hepatitis (HR = 2.53, CI: 1.12–5.73) were associated with increased risk of mortality after LT. Conclusion: The MELD and ascites are influential factors on waiting list mortality and occurrence of LT. Total life expectancy is not influenced by higher MELD

Descriptive Study of Occupational Accidents and their Causes among Electricity Distribution Company Workers at an Eight-year Period in Iran

Background: Occupational accidents are unplanned events that cause damage. The socio-economic impacts and human costs of accidents are tremendous around the world. Many fatalities happen every year in workplaces such as electricity distribution companies. Some electrical injuries are electrocution, electric shock, and burns. This study was conducted in an electricity distribution company (with rotational 12-hour shift work) in Iran during an 8-year period to survey descriptive factors of injuries. Methods: Variables collected included accident time, age of injured worker, employment type, work experience, injury cause, educational background, and other information about accidents. Results: Results indicated that most of the accidents occurred in summer, and 51.3% were during shift work. Worker negligence (malpractice) was the cause of 75% of deaths. Type of employment had a significant relationship with type of injuries (p < 0.05). Most injuries were electrical burns. Conclusion: High rate of accidents in summer may be due to the warm weather or insufficient professional skills in seasonal workers. Shift workers are at risk of sleep complaints leading to a high rate of work injuries. Acquiring knowledge about safety was related to job experiences. Temporary workers have no chance to work all year like permanent workers, therefore impressive experiences may be less in them. Because the lack of protective equipment and negligence are main causes of accidents, periodical inspections in workshops are necessary

Knowledge, Attitude and Practice of Women Regarding Health Hazards and Proper Methods of Storage and Use of Pesticides at Home in Abarkouh

Introduction: A large amount of pesticides is used worldwide in different locations including homes. Considering that using pesticides in the home is mainly done by women, this study was conducted to determine the knowledge, attitudes and practices of women regarding health hazards and proper methods of storage and use of pesticides in the home in Abarkouh. Materials and Methods: In this descriptive study, data were collected using cluster sampling and questionnaire by interviewing 210 eligible women in households. The questionnaire was included demographic information (age, education level, field of study, occupation, type of home), as well as knowledge, attitudes and practices of women. Validity and reliability of the questionnaire have been confirmed in previous studies. Data were analyzed by SPSS using nonparametric tests. Results: According to results, the mean score of attitude among different academic disciplines was statistically significantly (p = 0.049). In addition, there was a significant relationship between attitude score with practice (p = 0.003) and knowledge (p < 0.0001) scores. Conclusion:&nbsp;Considering the fact that people's knowledge about this subject was moderate, their knowledge should be increased to make their attitude and practice more desirable