A systematic review and meta-analysis of pregnancy and COVID-19: Signs and symptoms, laboratory tests, and perinatal outcomes

Background: Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 appeared in December 2019 in Wuhan, China. Objective: To investigate the clinical manifestations including signs and symptoms, laboratory results, and perinatal outcomes in pregnant women with COVID-19. Materials and Methods: Scholarly databases such as PubMed via LitCovid hub, Embase, Scopus, Web of sciences, and Google scholar were searched on April 7, 2020. Meta-analysis was performed via comprehensive meta-analysis software using the Mantel-Haenszel method. The event rate with 95% CI was calculated for each variable. Results: Ten studies were selected. The pooled prevalence for fever, post-partum fever, cough, myalgia, fatigue, dyspnea, sore throat, and diarrhea were 66.8%, 37.1%, 35%, 24.6 %, 14.9%, 14.6%, 11.5%, and 7.6%, respectively. Laboratory test results were 49.8% for lymphopenia, 47.7% for leukocytosis, 83.7% for elevated neutrophil ratio, 57% for elevated C-reactive protein, and 71.4% for decreased lymphocyte ratio. The rate of cesarean section for delivery in all cases was 84%. Of the newborns of the corona positive mothers, only one had a positive test result. Also, there was only one death due to a decreased lymphocyte ratio. Conclusion: Fever was the most common sign and symptom in pregnant women with COVID-19. Among the laboratory tests, the highest amount was related to elevated neutrophil ratio. It seems that due to the differences between pregnant women and the general population, special measures should be considered to treat these patients. Key words: COVID-19, Pregnancy, Diagnosis, Signs and symptoms, Meta-analysis

Fully robotic social environment for teaching and practicing affective interaction: Case of teaching emotion recognition skills to children with autism spectrum disorder, a pilot study

21st century brought along a considerable decrease in social interactions, due to the newly emerged lifestyle around the world, which became more noticeable recently of the COVID-19 pandemic. On the other hand, children with autism spectrum disorder have further complications regarding their social interactions with other humans. In this paper, a fully Robotic Social Environment (RSE), designed to simulate the needed social environment for children, especially those with autism is described. An RSE can be used to simulate many social situations, such as affective interpersonal interactions, in which observational learning can take place. In order to investigate the effectiveness of the proposed RSE, it has been tested on a group of children with autism, who had difficulties in emotion recognition, which in turn, can influence social interaction. An A-B-A single case study was designed to show how RSE can help children with autism recognize four basic facial expressions, i.e., happiness, sadness, anger, and fear, through observing the social interactions of two robots speaking about these facial expressions. The results showed that the emotion recognition skills of the participating children were improved. Furthermore, the results showed that the children could maintain and generalize their emotion recognition skills after the intervention period. In conclusion, the study shows that the proposed RSE, along with other rehabilitation methods, can be effective in improving the emotion recognition skills of children with autism and preparing them to enter human social environments

Usability Evaluation of Web-based Training Tools under WHO Family of International Classifications (WHO-FIC)

Introduction: Various training methods such as web-based training tools have been developed to achieve the potential benefits of classification systems developed by the World Health Organization (WHO). Given that users of these tools have different levels of capability, usability problems could reduce the speed and accuracy of learning among users interacting with these tools. This study aims to identify usability problems of web-based training tools under the WHO family of international classifications (WHO-FIC). Methods: In this descriptive and cross-sectional study, ten trained evaluators independently examined WHO-FIC training tools using the heuristic evaluation method. The identified problems were classified into 10 Nielsen’s usability heuristics. Then, their average severity was calculated. Results: In total, 40 usability problems were identified after merging and eliminating the duplicates. The highest number of problems was related to ICD-10 training tool (n=20). The highest number of problems was related to heuristics of aesthetic and minimalist design (25.0%), and user control and freedom (17.5%). Heuristics of flexibility and efficiency of use and helping users recognize, diagnose and recover from errors had the highest average severity of problems. Conclusion: Violating heuristics of aesthetic and minimalist design, user control and freedom and recognition rather than recall were among the most common problems of WHO-FIC training tools. Evaluators reported that half of the user interface problems of WHO-FIC training tools were of major and catastrophe type. Solving the usability problems of these tools could lead to ease of work, increased speed of learning and acceptance of these systems among users

The role of diffusion-weighted MRI on the study of brain complications related to heroin abuse

Heroin has physical effects on many parts of the body, for example, respiratory and digestive system, muscles, and nervous system. Neurologic complications include brain abscess, neuropathy, transverse myelitis, and leukoencephalopathy.Magnetic resonance image is more sensitive in detecting lesions with low signal on T1W and high signal on T2W, and FLAIR images in the white matter and other areas of brain. Imaging findings are similar to other leukoencephalopathies (hereditary diseases, abnormal metabolic diseases, and intoxications).In the course of finding ways to differentiate heroin-induced spongiform leukoencephalopathy from other leukoencephalopathies, attention has been changed to diffusion magnetic resonance imaging in recent years.Nevertheless, studies do not verify that diffusion-weighted image is a valuable tool in establishing the diagnosis

Spontaneous miscarriage driven by maternal genetic mutation at position of PAI-1-844G/A: shed light on a race-specific genetic polymorphism

Abstract Objective Association between a genetic polymorphism and disease, either positively or negatively, within a population may not necessarily predict association in other race-ethnic populations. The aim of this study was to genotype well recognized thrombophilia associated polymorphisms as common risk factors for miscarriage and investigate their benefit to use as risk factors in southwest region of Iran females (Khuzestan) in the Arabs ethnic minority group with spontaneous miscarriage. We developed a Reverse Dot Blot Assay for the genotyping of four polymorphisms. Results There were significant differences in the genotype distribution and allelic frequencies of the MTHFR 1298 A > C, MTHFR 677 C > T, Factor V Leiden 1691 G > A, PAI-1-844G > A polymorphisms between the case and control groups. The MTHFR 1298 A > C, MTHFR 677 C > T and Factor V Leiden 1691 G > A polymorphisms were significantly associated with spontaneous miscarriage risk. Unlike some other race-ethnic populations, PAI-1-844G > A polymorphism was associated with risk of developing unplanned miscarriage in Iranian Arabs ethnic minority group females

Small bowel hemangioma causing perforation

Background: Benign vascular tumors that can be found anywhere in the body are defined as hemangiomas The most common clinical manifestation is gastrointestinal bleeding (GIB). Other possible signs and symptoms could be Iron deficiency anemia, intestinal obstruction, abdominal pain, intramural hematoma, perforation, platelet sequestration, intussusception, or perforation. The main diagnostic methods are Computed tomography (CT) and contrast-enhanced computed tomography (CECT), and capsule endoscopy is helpful too. The therapeutic plan depends on the disease development and the condition of the patient, but, surgical resection is the choice for most patients. Case presentation: A 6-year-old girl with the chief complaint of acute abdominal pain that was accompanied by loss of appetite, nausea, and vomiting was admitted. There was no sign of GIB. The first diagnosis of the patient was perforation of the intestinal wall. In the laparotomy operation, a perforation was seen and resection and anastomosis were done. The pathological studies revealed the signs of hemorrhage of hemangioma and so hemorrhagic necrosis and perforation due to it. Conclusion: Although small intestinal hemangiomas are rare and, in their complication, perforation is unusual, they should be considered in the differential diagnosis of acute abdominal pain

The effect of isotretinoin (roaccutane) therapy on depression and quality of life of patients with severe acne.

Acne is the most common skin disease and isotretinoin is the most powerful drug among the various drugs used for its treatment, but it has some adverse effects. The aim of this study was to evaluate the effect of isotretinoin on depression and quality of life of a group of patients undergoing isotretinoin therapy before and after the treatment course.In this prospective study, 98 patients with severe acne were enrolled consecutively and underwent isotretinoin therapy receiving 0.5 mg/kg/d of isotretinoin for 16 weeks. Isotretinoin effects on quality of life and depression were evaluated using Dermatology Life Quality Index (DLQI) and Beck Depression Inventory (BDI) questionnaires, respectively.In this study, 98 patients suffering from severe acne (38 males and 60 females) were enrolled. Treatment of acne was associated with improvement of quality of life scores in both male and female patients (p = 0.001). Considering the cutoff value of 13 for mild depressive mood in the BDI score, in total, 48 (49%) of the enrolled patients (21 males and 33 females) had a mild depressive mood before the commencement of the treatment in this study. The analysis of before and after treatment BDI scores showed that the number of patients and also the mean score of BDI were increased in both male and female patients after the treatment (

Pathological evaluation of ganglion cells in biopsies from upper side of the dentate line in patients with perianal problems

Introduction: Constipation is one of the most common complaints of individuals, which may present with complication like hemorrhoid and fissure. Hirschsprung is a disease presenting with chronic constipation and its diagnosis may be delayed until adulthood. It is diagnosed by biopsies from anorectal transitional zone. This study aimed to evaluate the association between Hirschsprung and anorectal problems. Method: Sixty three patients with anorectal problems who underwent surgery enrolled in this study. Some consecutive biopsies were obtained from anal canal at 2, 4 and 6 cm above the dentate line. Biopsies were assessed for ganglion cells changes. Patients' data and biopsies results were analyzed with SPSS version18. Results: Out of 63 patients 29 (46 %) patients were female and 34 (54 %) were male with the mean of 32.65 ± 13.73 years. Fifty six (73 %) patients complained from constipation with the mean time of 57.65 ± 45.21 months. Aganglionic zone were reported in six patients with the mean length of 43.33 mm. There was not any relation between anal ganglion cells pathology and constipation (p=0.363), but there was a significant relation between duration of constipation and pathologic changes (p=0.001). The ratio of constipation duration to age was related to anal ganglion cell pathology (p=0.001). Hemorrhoid degree was also affected anal ganglion cells pathology (p=0.037). Conclusion: The relation between Hirschsprung's disease and anorectal problems in adults were significant. The pathologic findings were more presented in younger patients, and those with longer history of constipation and lower degree hemorrhoids. Key words: Anal ganglion cells, Hemorrhoids, Constipatio