Evaluation of the Effect of Combination Therapy on Treatment of COVID-19: A Cohort Study

Background: COVID-19 is a new disease for which a definitive treatment has not yet been proposed. Objectives: The present study aimed to investigate the effect of combination therapy on the treatment of COVID-19 due to the importance of finding an appropriate treatment for this epidemic disease. Methods: This two-center cohort study included 175 confirmed COVID-19 inpatients at two medical centers designated for the treatment of COVID-19 patients in Qom and Qazvin, Iran. In this study, four different groups of drug regimens were studied which included G1 (azithromycin, prednisolone, and naproxen), G2 (lopinavir/ritonavir, azithromycin, naproxen, and prednisolone), G3 (hydroxychloroquine, azithromycin, naproxen, and prednisolone), and G4 (levofloxacin, vancomycin, hydroxychloroquine, and oseltamivir). It should be noted that G1, G2, G3, and G4 treatment regimens were used on 48, 39,30, and 77 patients, respectively. Results: The study participants included 175 confirmed COVID-19 patients with mean±SD age of 58.9 ±15.1 years, out of whom 80 (46%) patients were male and the rest were females. The results indicated that the hospital stay period was significantly shorter in the G1 compared to other groups (G1:5.9±2.4, G2:8.1±4.2, G3: 6.3±1.7, and G4: 6.4±2.9; [P-value=0.008]). It should be noted that pulse rate, oxygen saturation, hemoglobin, and platelet count (PLT) changed significantly during the study in four treatment groups; however, a significant change in temperature, creatinine, and white blood cell (WBC) was observed only in G3, G4, and G1 groups, respectively. The number of ICU admissions and deaths were not statistically significant among the patients who received the four treatment regimens (P=0.785). Based on the results, the history of ischemic heart disease, baseline oxygen saturation, WBC, neutrophil, lymphocyte count, and C-reactive protein (CRP) are the risk factors for the prolonged hospital stay in COVID-19 patients. Conclusion: The obtained results in this study indicated that the combination of azithromycin, prednisolone, and naproxen is the most effective regimen for the treatment of COVID-19, compared to three other combination treatment regimens. Keywords: Anti-inflammatory drugs, Antiviral drugs, Combination therapy, Corticosteroid, COVID-19, Immunomodulators drug

Bivariate Poisson Model Using Multi-Level Method and Its Application in Analyzing the Factors Affecting Sick Leave of Employees of a Steel Company

Background: One of the issues that affects the economic productivity is the absence from work due to illness (sick leave). Considering the importance of this subject, in this study, the factors affecting the number of days of sick leave due to occupational and internal diseases have been investigated. Methods: This cross-sectional study was performed on male employees working in Mobarakeh Steel Company in Isfahan, Iran, from 2011 to 2015. In this study, the response variables were the number of days of sick leave due to internal and occupational diseases, and the covariate variables were shift work, smoking status, education, age, work experience, body mass index (BMI), and Framingham Risk Score (FRS). Data were analyzed by bivariate Poisson model using multi-level method. Findings: The present study was performed on 17988 male workers with mean age of 38.13 ± 7.56 years and mean work experience of 6.79 ± 5.95 years. The results showed that the variables of shift work (eβ = 1.47), smoking (eβ = 1.82), education (eβ = 1.11), age (eβ = 1.02), work experience (eβ = 1.05), BMI (eβ = 1.02), and FRS (eβ = 1.08) had a significant effect on the average sick leave due to internal diseases; however, of the above variables, only four variables of smoking (eβ = 0.74), education (eβ = 1.19), work experience (eβ = 1.04), and FRS (eβ = 1.02) had a significant effect on the average sick leave due to occupational diseases. Conclusion: According to the results of this study, by controlling the effective variables, it is possible to provide appropriate strategies to reduce the number of days of sick leave

Assessment of transient elastography (FibroScan) for diagnosis of fibrosis in non-alcoholic fatty liver disease: A systematic review and meta-analysis

Background: Transient elastography (TE) is a new modality for the diagnosis of liver fibrosis caused by various etiologies. This study was conducted to determine the accuracy of TE in detecting the different stages of liver fibrosis in non-alcoholic fatty liver disease (NAFLD) patients. Methods: MEDLINE/PubMed, Embase, Ovid, Cochrane Library, American College of Physicians (ACP) Journal Club, Google Scholar, Database of Abstracts of Reviews of Effects, and Web of Science that evaluated the liver stiffness by means of TE and liver biopsy were enrolled in this systematic review and meta-analysis. Published articles were extracted from 2002 to March 2015. Results: A total of 7 articles from 114 papers were included which consisted of 698 patients. The results indicated that when F ≥3, the outcomes were 93.7% (95% confidence interval (CI): 92-95.5), 91.1% (95% CI: 89-93.2), 82.4% (95% CI: 79.9-84.9), and 95.9% (95% CI: 94.4-97.4) for sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), respectively. With fibrosis stage ≥4, it has reached the sensitivity of 96.2 % (95% CI: 94.5-97.8), a specificity of 92.2% (95% CI: 89.9-94.6), a PPV of 5.5% (95% CI: 51.2-59.8) and NPV of 98.5% (95% CI: 97.4-99.5). Conclusion: We concluded that as the pathological fibrosis increases, the sensitivity, specificity and NPV of TE in the diagnosis of fibrosis improves in NAFLD patients. TE can be considered as a unique alternative instead of liver biopsy in NAFLD patients and it has an important role in the exclusion of liver cirrhosis. More studies are required to confirm the results

The relationship between shift work and Framingham risk score: A five-year prospective cohort study

BACKGROUND: There is a small number of studies that considered the relationship between shift work (SW) and Framingham risk score (FRS). This study prospectively examined the association between SW and FRS among man workers based on the multilevel modeling approach.METHODS: This five-year prospective cohort study was done among workers (using stratified random sampling) who work in Esfahan’s Mobarakeh Steel Company (EMSC), Iran, from March 2011 to February 2015.RESULTS: The study sample included 1626 man workers (mean age = 40.0 ± 6.2). Among these subjects, 652 (40.01%), 183 (11.3%) and 791 (48.6%) were day workers, weekly rotating shift workers and routinely rotating, respectively. After controlling unbalanced variables, there was no any significant association between SW and FRS.CONCLUSION: The results of this prospective cohort study did not show a relationship between SW and FRS. </div

The relationship between attachment and psychological distress with regard to the mediating role of mindfulness

Background: Various researches have studied the relationship between psychological distress and different variables. The present study aimed to predict psychological distress according to the attachment style with respect to the mediating role of mindfulness. Materials and Methods: The present study follows a design of correlational studies. The sample of research included 250 undergraduate and M. D. students of Shahed University studying in the first semester of a 2017-2018 academic year. Data were collected using the Depression, Anxiety and Stress Scale-21 item (DASS-21), Experiences in Close Relationship-Revised (ECR-R) and Five Facet Mindfulness Questionnaire (FFMQ). Then, the data were analyzed using the SPSS-23 and AMOS-18 software. Results: The results showed a significant positive relationship between attachment anxiety and the components of psychological distress (anxiety, depression and stress), as well as a significant negative relationship between attachment anxiety and mindfulness. Also, a significant negative relationship was found between mindfulness and the components of psychological distress. In addition, a significant negative relationship was found between attachment avoidance and mindfulness. The results of the structural equation modeling confirmed the mediating role of mindfulness in the relationship between attachment anxiety and the components of psychological distress. The effect of attachment avoidance on the components of psychological distress was only confirmed in the presence of mindfulness as a mediating variable, rather than directly. Conclusion: According to the findings of the current research, the mediating role of mindfulness in the effect of attachment anxiety and attachment avoidance on the components of psychological distress is confirmed. These findings seem to be applicable in different humanistic areas like interpersonal relationships, educational, family and therapeutic fields

The Effect of Osteoporosis Prevention Education on Knowledge, Attitude and Behavior of Adolescent Female Students in Kermanshah, Iran

Background and Objectives: Osteoporosis is a common metabolic bone disorder among females. Primary prevention is the easiest and cheapest way to deal with this condition. Therefore, it is important to educate about osteoporosis risk factors and preventive behaviors during adolescence. This study aimed to evaluate the effect of osteoporosis prevention education on knowledge, attitude and practice of adolescent female students in Kermanshah, Iran. Materials and Methods: We performed this quasi-experimental research in 118 adolescent female students in Kermanshah in 2014. The participants were selected with multistage cluster sampling form guidance schools of the city. They were allocated randomly to intervention (n=53) and control (n=65) groups. We collected data by a four-part questionnaire including demographic information, knowledge, attitude and behavior about osteoporosis prevention. Data were analyzed in SPSS 19 using independent t-test, paired t-test, chi-squared and Pearson’s correlation. Results: The mean scores of knowledge, attitude and practice displayed no significant difference between case and control groups at pre-intervention (P>0.05). However, the averages of knowledge (P=0.024) and attitude (P=0.003) increased significantly in the training group after performing the educational program. Although, the behavior mean had no significant difference between the two groups at post-intervention (P= 0.086). Conclusions: Educating about osteoporosis prevention led to promote the knowledge and attitude of adolescent female students in Kermanshah. However, this training had no influence on behavior. It is necessary to consider this problem in designing educational interventions in this target group

Predicting Suicidal Thoughts Based on Components of difficulty in emotion regulation in suicide ideators

Aims: Suicide is a fundamental cause of premature deaths in the world. Therefore, it is very important to identify predictors of suicide. The aim of the present study was to predict suicidal ideation based on the components of difficulty in emotion regulation in suicide ideators. Materials & Methods: The statistical population of this study was the patients referring to the psychiatric clinics in Imam Reza and Imam Ali hospitals in Bojnourd with suicidal thoughts in the spring of 2019, which, according to the latest report, consisted of 233 people. Using the available sampling method, 141 patients were selected and completed the difficulty in emotion regulation questionnaire and Beck's suicidal ideation questionnaire. Findings: In the present study, data were analyzed based on the information from 141 subjects, 55 of whom were male, and 86 were female. The mean age of participants was 23.5 years. The results of regression analysis showed that, among the components of difficulty in emotion regulation, three subscales of limited access to emotion regulation strategies (P<0.001), non-acceptance of emotional responses (P<0.05), and lack of emotional clarity (P<0.01) have been able to predict the suicidal ideation score significantly. Conclusion: Based on the findings of this study, it can be concluded that emotion regulation strategies, acceptance of emotional responses, and emotional clarity can predict suicidal thoughts

Study of Sciatic Pain and Effect of Fasd (bloodletting) on its Treatment from the Viewpoint of Persian Medicine

زمینه و هدف: با توجه به شیوع بالای درد سیاتیک ازکارافتادگی و غیبت از محل کار، هزینه‌های سنگین درمانی، عوارض جانبی درمان‌های دارویی و جراحی در طب کلاسیک بر آن شدیم با مطالعه در منابع طب ایرانی و پژوهش‌های جدید یک روش درمانی مؤثر، کم‌عارضه و کم‌هزینه را به جامعه پزشکی معرفی نماییم. این بررسی بر اساس دیدگاه طب ایرانی نسبت به اسباب و علائم و علاج (فیزیوپاتولوژی، اتیولوژی، سمیولوژی و درمان) بیماری‌ها که همان طب اخلاطی است، طراحی شده است. مواد و روش‌ها: این مطالعه یک مطالعه کیفی است که طی یک مدل هیبرید در سه مرحله انجام می‌گیرد: 1ـ مرحله تئوریک؛ 2ـ مرحله میدانی؛ 3ـ مرحله ترکیبی (جمع‌بندی). یافته‌ها: درد سیاتیک از دردهای شایع و ناتوان‌کننده است که در طب رایج درمان قطعی، مؤثر و بدون عارضه‌ای برای آن وجود ندارد، لیکن با توجه به اسباب و علل (فیزیوپاتولوژی و اتیولوژی) آن از دیدگاه طب ایرانی که همان غلبه اخلاط و سوء مزاج‌های حاصله به علاوه ضعف مفصل می‌باشد و در اکثر موارد با ریزش ماده در عضو بیماری به وجود می‌آید، درمان‌های متعددی به تناسب علل آن معرفی شده است. نتیجه‌گیری: بر اساس آموزه‌های طب ایرانی و با توجه به نتایج پژوهش‌های جدید درمان بیماری سیاتیک بر اساس عامل مسبب بیماری متفاوت بوده و در انواع آن روند درمانی بر اساس رفع علت ایجادکننده بیماری، دفع خلط غالب، تعدیل مزاج و تقویت عضو می‌باشد، و یکی از روش‌های درمانی که در اکثر موارد بر آن تأکید شده است، انجام فصد در درمان و حتی گاهی در پیشگیری می‌باشد.Background and Aim:&nbsp;Due to the high prevalence of sciatic pain, disability and absence from the workplace, heavy cost of treatment, side effects of medical treatments and surgery in classical medicine, we decided to study a new method of treatment in Iranian medicine sources. Effective, low-cost and low complication medical education. This study is based on the viewpoint of Iranian medicine about physiopathology, etiology, semiology and treatment of diseases, which is a bodily humors medicine. Materials and Methods:&nbsp;This qualitative study of concept development employed the hybrid model in 3 phases: 1- Theoretical phase; 2- Fieldwork phase; 3- Incorporation. Findings:&nbsp;Sciatica is a common and debilitating pain that is not definitive, effective and uncomplicated in classical medicine. However, with regard to physiopathology and etiology, from the perspective of Iranian medicine, bodily humors and dystemperaments, as well as joint weakness, are caused by decrease of substance in the disease state. Several treatments have been proposed, according to the causes. Conclusion:&nbsp;Based on the teachings of Iranian medicine and according to the results of new research, treatment of sciatica is different based on the causative agent of the disease, and in its various therapeutic regimens, based on the elimination of the cause of the disease, the dominant bodily humors, modulation of temperament and strengthening of the member. In addition, phlebotomy is one of the treatment methods that is emphasized in most cases for the treatment, and sometimes even to prevent it. &nbsp; Please cite this article as:&nbsp;Amini MH, Esmaeili SS, Mehdi Barzi D, Gholami Fesharaki M. Study of Sciatic Pain and Effect of Fasd (bloodletting) on its Treatment from the Viewpoint of Persian Medicine.&nbsp;Med Hist J&nbsp;2018; 9(33): 93-106

A Survey and Prioritizing of Medicinal Herbs Effective on Memory Improvement in Iranian Traditional Medicine

زمینه و هدف: حافظه یکی از عملکردهای مغز است که برای انجام امور روزمره، یادگیری و ادامه حیات لازم است. در سال‌های اخیر، استفاده از گیاهان دارویی برای درمان فراموشی و تقویت حافظه، موضوع بسیاری از پژوهش‌های پزشکی بوده است. هدف این مطالعه بررسی و اولویت‌بندی گیاهان دارویی تقویت حافظه درکتب طب سنتی ایرانی می‏باشد. مواد و روش‌ها: در این تحقیق کتابخانه‌ای، ابتدا از کتاب قانون، 33 مفرده دارویی (ماده ساده گیاهی، معدنی، حیوانی) با واژگان کلیدی که مرتبط با تقویت مغز، حافظه، ذهن، حواس، فهم، اثر بر نسیان، نافع برای مغز و فساد ذکر بود، استخراج گردید، سپس از بین این مفردات، 12مفرده گیاهی که اختصاص بیشتری به حافظه داشت، انتخاب و تأثیر آن‌ها بر تقویت حافظه، در کتاب‌های القانون فی الطب، الحاوی فی الطب، الشامل فی الصناعة الطبیه، مخزن الادویه، تحفة المومنین، الابنیه عن حقایق الادویه و المعتمد فی الادویة المفرده مورد بررسی قرار گرفت و بر اساس توصیف هر مفرده گیاهی در کتاب‌ها، امتیاز ویژه‌ای به هر یک تعلق گرفت و مجموعه امتیازات، مورد ارزیابی نهایی قرار گرفت. یافته‌ها: 12 گیاه دارویی تقویت حافظه به ترتیب بیشترین امتیاز عبارتند از: 1ـ کندر؛ 2ـ بلادر؛ 3ـ سعد، زنجبیل، عود؛ 4ـ هلیله کابلی؛ 5ـ دارفلفل، آمله، وج، خردل؛ 6ـ صبر، روغن گل. نتیجه‌گیری: مطالعات متعدد نشان داده که گیاهان بر روی یادگیری و حافظه اثرات مطلوبی دارند. به نظر می‌رسد بررسی اثربخشی گیاهان دارویی تقویت حافظه یادشده به ویژه مفردات با امتیاز بالاتر، نیازمند تحقیقات بالینی در افراد سالم و بیماران با اختلال حافظه می‌باشد که در صورت تأیید، کمک مؤثری به تقویت حافظه افراد سالم و درمان بیماران می‌نماید.Background and Aim: In recent years, the use of medicinal herbs for memory improvement and the treatment of Alzheimer's disease has been the subject of many medical researches. The aim of this research is study and prioritizing of medicinal herbs enhances memory in Iranian Traditional medicine.Materials and Methods: First, 33 medicinal Mofradeh (single drug which can be herbal, animal or mineral) derived from the book Canon of Medicine by keywords which were related to enhancing of memory, mind, senses and understanding, effective on amnesia (Nesyan), beneficial for the brain and memory disorder. Then 12 Mofradeh that were herbal and specific for memory improvement more than others were selected from 33 drugs and was searched their impact on memory in books Makhzan al-advieh, al-Havi fi-Alteb, al-Shamel fi-alsenaat altebbiah, Tohfeh-Almomenin, al-Abnieh aan Haghayegh al-advieh. Al-Moetamed fi-al-advieh. Each of Mofradat, obtained special score based on descriptions in books and were prioritized.Findings: 12 medicinal herbs memory enhancer are respectively: 1- Boswellia sp; 2- Anacardium occidentale; 3- Cyperus rotundus, Zingiber officinalis, Aquilaria malaccensis; 4- Terminalia chebula; 5- Piper elongatum, Phylanthus embolica, Acorus calamus,Brassica nigra; 6- Aloe sp., Rosa damascena oil.Conclusion: Numerous studies have shown beneficial effects of plants on learning and memory improvement. It seems the survey of effectiveness of medicinal herbs enhancing memory that mentioned specially herbs with more score need to clinical research in healthy people and patients with memory disorder and it helps memory enhancing in healthy people and treatment of patients effectively, if approved. &nbsp; Please cite this article as: Mirheidary R, Esmaeili Saber SS, Shaeiri MR, Gholami Fesharaki M. A Survey and Prioritizing of Medicinal Herbs Effective on Memory Improvement in Iranian Traditional Medicine. Med Hist J 2018; 10(35): 7-19. Please cite this article as:&nbsp;Mirheidary R, Esmaeili Saber SS, Shaeiri MR, Gholami Fesharaki M. A Survey and Prioritizing of Medicinal Herbs Effective on Memory Improvement in Iranian Traditional Medicine.&nbsp;Med Hist J&nbsp;2018; 10(35): 7-19