Risk factors of developing critical conditions in Iranian patients with COVID-19

COVID-19 due to novel Coronavirus was first reported in Wuhan, China. Nowadays, the Islamic Republic of Iran stands among countries with high COVID-19 prevalence and high burden of disease. Since the medical resources are limited, we aimed to identify the risk factors for patients developing critical conditions. This can help to improve resource management and treatment outcomes. In this retrospective study, we included 12,677 patients who were from 26 hospitals, supervised by Tehran University of Medical Sciences with signs and symptoms of COVID-19, until April 12. University integrated IT system was adopted to collect the data. We performed Logistic regression to evaluate the association between death in COVID-19 positive patients and other variables. Cough, respiratory distress and fever were the most common symptoms in our patients, respectively. Cancer, chronic lung diseases and chronic neurologic diseases were the strongest risk factors for death in COVID-19 patients. © 202

Survival rate of colorectal cancer in Iran: A systematic review and meta-analysis

Background: Different studies have been conducted to estimate the survival rate of colorectal cancer in Iran but there is no overall estimate of the survival rate. The aim of this study was to calculate the pooled 1, 3, and 5-year survival rate of the patients with colorectal cancer in Iran. Methods: To retrieve relevant studies, we conducted a systematic search in Iranian databases, including Iran Medex, Magiran, SID, and international databases such as Medlin/PubMed, Scopus, and Google scholar using "Colorectal Neoplasms" and "Survival Rate" as keywords up to December 1st, 2017. We used random effect model to estimate pooled 1, 3, and 5-year survival rates of the patients with colorectal cancer in Iran. To assess the heterogeneity, we used Chi-squared test at the 5 significance level (p < 0.05) and I2 Index. We used meta-regression and subgroup analysis to find a potential source of heterogeneity. Results: After a systematic search, 196 articles were found, of the 38 studies met the eligibility criteria and are included in our meta-analysis. The pooled 1, 3, and 5-year survival rates in patient with colorectal cancer were 0.84 (95 CI: 0.81-0.87), 0.64 (95CI: 0.59-0.70), and 0.54 (95CI: 0.49-0.58) respectively. The 5-year survival rate in the subgroup of women was 0.5 (0.44-0.56) and in male subgroup was 0.44 (0.40-0.48). In a subgroup of the tumor site, the 5-year survival rate in colon cancer was 0.6 (0.49-0.75) and rectum cancer was 0.54 (0.36-0.69). In multivariable models, there was a significant association between years of study and 5-year survival rate as a source of heterogeneity (β = 18.9, P=0.01). Conclusion: According to the results of this study, women had a better survival rate than men, and according to the tumor site, the 5-year survival rate in colon cancer was better than the rectum cancer. © 2019 Asian Pacific Organization for Cancer Prevention

The Autoimmune Manifestations in Patients with Genetic Defects in the B Cell Development and Differentiation Stages

Purpose: Primary B cell defects manifesting as predominantly antibody deficiencies result from variable inborn errors of the B cell lineage and their development, including impairments in early bone marrow development, class switch recombination (CSR), or terminal B cell differentiation. In this study, we aimed to investigate autoimmunity in monogenic patients with B cell development and differentiation defects. Methods: Patients with known genetic defects in the B cell development and differentiation were recruited from the Iranian inborn errors of immunity registry. Results: A total of 393 patients with a known genetic defect in the B cell development and differentiation (257 males; 65.4%) with a median age of 12 (6-20) years were enrolled in this study. After categorizing patients, 109 patients had intrinsic B cell defects. More than half of the patients had defects in one of the ATM (85 patients), BTK (76 patients), LRBA (34 patients), and DOCK8 (33 patients) genes. Fifteen patients (3.8%) showed autoimmune complications as their first manifestation. During the course of the disease, autoimmunity was reported in 81 (20.6%) patients at a median age of 4 (2-7) years, among which 65 patients had mixed intrinsic and extrinsic and 16 had intrinsic B cell defects. The comparison between patients with the mentioned four main gene defects showed that the patient group with LRBA defect had a significantly higher frequency of autoimmunity compared to those with other gene defects. Based on the B cell defect stage, 13% of patients with early B cell defect, 17% of patients with CSR defect, and 40% of patients who had terminal B cell defect presented at least one type of autoimmunity. Conclusion: Our results demonstrated that gene mutations involved in human B cell terminal stage development mainly LRBA gene defect have the highest association with autoimmunity

Investigating the effect of education on knowledge and practice in preventing tuberculosis in eastern Iran

Tuberculosis is the leading cause of death and a decline in the quality of life and economic losses caused by single-agent infectious diseases in the world. This study was aimed at determining the effect of education on knowledge and practice of people referred to the urban health centers of Kashmar in preventing Tuberculosis (TB). In this interventional study, 90 people who were referred to the urban health centers of Kashmar from 2012 to 2013 were selected based on inclusion criteria. They were randomly divided into intervention (n = 45) and control (n = 45) groups. Data were collected by interview and observation questionnaires. The intervention group distributed in four sessions and received training in the prevention of TB. The reliability of the knowledge and practice measuring tool with an emphasis on the internal consistency of the instrument led to the inclusion of the Cronbach�s alpha coefficient 88. All gathered data from questionnaire and interview were analyzed. The mean of knowledge and practice in the intervention group before the study were 21.8 (4.4) and 6.4 (1.9), respectively. We found a statistically significant difference in knowledge and practice parameters in the interventional group before and after the intervention, P < 0.001 and 0.003, respectively. Conversely, in the control group, we found no statistically significant difference in parameters before and after study. Based on the findings, we conclude that education is effective in improving the levels of knowledge and practice of the individuals who participated in preventing tuberculosis. © 2019, © 2019 Institute of Health Promotion and Education