Research articles
Gholamreza Poorheidari; Mahdi Mashhadi Akbar Boojar; Ahmad Soltani
Volume 22, Issue 8 , 2020
Abstract
Background: A conceptual model is always a suitable way to show the relationship between the different components of a process or among different processes. In the field of incident management, there are several models. However, there is almost no simple, natural, conceptual model to show the relationship ...
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Background: A conceptual model is always a suitable way to show the relationship between the different components of a process or among different processes. In the field of incident management, there are several models. However, there is almost no simple, natural, conceptual model to show the relationship between disaster risk management.
Methods: Because of the need for the development of a simple model that can quickly and at a glance relate the overall steps and components of the risk management process and various phases of disaster management, this model has been invented based on the evaluation of previous studies and reviewing current literature as well as refining the research and innovation done by the authors.
Results: In this article, a new model, which is called the Egg model, including the shell, the white (albumen) and the yellow (yolk) parts, is introduced. In which, risk management includes three steps. The first step is the assignment of a body, either a person, team or organization, as responsible (the resembling the shell). In the second step, the body does the assessment of the risk (resembling the white part). Risk assessment, on its own, includes risk identification, risk analysis, and risk evaluation. Finally, (resembling the yellow part), treatment of the risk(s) is begun which includes, prevention and mitigation, and preparedness before the disaster and, response and recovery after the disaster occurrence. Obviously, without an intact shell, the whole egg (albumen and yolk) will decay and all resources will be lost. Also without assessment of the risks, proper and effective management of the disaster is almost impossible. The third step of the risk management, the risk treatment, is in fact the disaster management.
Conclusion: This simple model shows the relationship between risk management and risk treatment. Although this model may have oversimplified the process of Risk Management, it helps to create a unique overview and understanding for almost everyone
Research articles
Jianli Cui; Youfu Ke
Volume 22, Issue 8 , 2020
Abstract
Context: Coronavirus disease 2019 (COVID-19) has progressed into a public health emergency of international concern. Passive immunotherapy has been successfully used for the treatment of infectious diseases since the 1890s. It is necessary and constructive to compare and analyze COVID-19 ...
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Context: Coronavirus disease 2019 (COVID-19) has progressed into a public health emergency of international concern. Passive immunotherapy has been successfully used for the treatment of infectious diseases since the 1890s. It is necessary and constructive to compare and analyze COVID-19 convalescent plasma (CCP) randomized controlled trials (RCTs) to help clinicians to have a potential option for COVID-19.
Evidence Acquisition: In this study, eight databases were searched on May 1, 2020, such as China National Knowledge Infrastructure, PubMed, and Cochrane Library, with the search fields of "Title Abstract Keyword" of "Convalescent plasma AND COVID-19" or " Convalescent plasma AND SARS-CoV-2". The outcome of interest was clinical RCTs for COVID-19.
Results: The search retrieved nine relevant CCP protocols for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). All nine trials were randomized, parallel assignment, interventional, clinical treatment studies with NCT04344535, NCT04345289, and NCT04323800 masking and the rest open-label. The estimated enrollment is within the range of 40-1,500 subjects, and five trials will be finished in 2020 as opposed to two in 2021 and two in 2022. Except for NCT04323800 on the prevention of COVID-19, other eight trials will test and verify the effectiveness and safety of CCP for the treatment of COVID-19.
The used dosage of CCP is within the range of 200-600 mL. NCT04344535, NCT04323800, and NCT04346446 use standard donor plasma in controlled groups in comparison to NCT04348656, NCT04342182, NCT04333251, and NCT04345523 without any positive drug in controlled groups. NCT04332835 adds hydroxychloroquine to both groups, and only NCT04345289 is a six-armed placebo-controlled trial.
Primary and secondary outcome measures are differently expressed in the nine trials. Nevertheless, they can be summarized as ? changes in time, day, and number of a 7-point ordinal scale. There are ? changes in SARS-CoV-2 ribonucleic acid (i.e., viral load), anti-SARS-CoV-2 antibody titers (i.e., immunoglobulin M and immunoglobulin G), C-reactive protein, lymphocyte count, lactate dehydrogenase, and interleukin 6 on a specified day or during a specific period.
Conclusion: The nine well-designed RCT trials will establish the efficacy of CCP for the treatment of SARS-CoV-2 from the perspective of evidence-based medicine.
Research articles
Behzad Rahimi; Reza Hajizadeh; Hamidreza Poorhosseini; Ebrahim Nematipour
Volume 22, Issue 8 , 2020
Abstract
Background: The assessment of potential benefits and harms of a medical procedure is essential for both physicians and patients to make an informed choice among treatment options. There is a paucity of studies on the role of creatine kinase-MB (CKMB) in the prediction of patient outcome after elective ...
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Background: The assessment of potential benefits and harms of a medical procedure is essential for both physicians and patients to make an informed choice among treatment options. There is a paucity of studies on the role of creatine kinase-MB (CKMB) in the prediction of patient outcome after elective percutaneous intervention
Objectives: The current study aimed to assess the association of CKMB level with demographic characteristics and major adverse cardiac events (MACES) after percutaneous coronary intervention (PCI) with drug-eluting stent implantation.
Methods: The study was conducted based on the data concerning the consecutive patients hospitalized for PCI and followed for 12 months. We examined the association between CKMB levels at 12 h post-PCI in patients with drug-eluting stent implantation and demographic characteristics. MACEs were defined as death, myocardial infarction, the need for re-revascularization in the first 48 h after the procedure and during a 1-year follow-up in 2898 patients who underwent PCI in Tehran Heart Center within 2015-2016.
Results: In multivariate logistic regression, after adjustment for differences, no relationship was observed between CKMB level at 12 h post-PCI and 12-month MACEs; nonetheless, in-hospital MACEs were higher in patients who had CKMB> 3 times the upper limit of normal. Furthermore, thrombus, angulated segment, and coronary perforation during the procedure were more prevalent in patients with higher CKMB levels.
Conclusion: The obtained results demonstrated that in patients with elective drug-eluting stent implantation, the moderate elevation of post-procedural CKMB>3 times was associated with in-hospital MACEs. Moreover, no association was found between 1-year adverse events and >3 times the elevation of CKMB.
Research articles
Junran Zhang; Kaiyan Shao; Shuguo Yang; Qinghua Ma
Volume 22, Issue 8 , 2020
Abstract
Background: Coronary heart disease (CHD) is myocardial ischemia caused by coronary atherosclerosis and stenosis.
Objectives: This study aimed to investigate the relationship of CHD with glycated albumin (GA), glycosylated hemoglobin (HbA 1c), glucose (Glu), homocysteine (Hcy), triglyceride (TG), and ...
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Background: Coronary heart disease (CHD) is myocardial ischemia caused by coronary atherosclerosis and stenosis.
Objectives: This study aimed to investigate the relationship of CHD with glycated albumin (GA), glycosylated hemoglobin (HbA 1c), glucose (Glu), homocysteine (Hcy), triglyceride (TG), and apolipop protein A (apoA) levels in elderly patients with type 2 diabetes mellitus (T2DM). Moreover, it was attempted to predict which changes had a significant correlation with the occurrence of CHD in these biochemical indicators.
Methods: This clinical cohort study included a total of 472 patients admitted to our hospital from June 2018 to June 2019. They were then divided into three groups of concurrent (n=168, T2DM complicated with CHD), DM (n=148, T2DM alone), and control (n=156, healthy individuals).
Results: There were significant differences between the disease group (i.e., DM and concurrent groups) and control group in terms of GA (P=0.013, 28.58±8.01 vs. 15.77±1.44), HbA 1c (P=0.022, 9.5±1.5 vs. 5.5±0.5), Glu (P=0.012, 8.54±2.23 vs. 4.12±0.39), Hcy (P=0.031, 11.16±3.28 vs. 5.03±2.87), TG (P=0.021, 1.83±0.49 vs. 0.84±0.18), and apoA (P=0.031, 1.10±0.12 vs. 1.30±0.18).
Moreover, GA (P=0.025, 27.14±6.34 vs. 28.58±8.01; concurrent group vs. DM group), HbA 1c (P=0.033, 8.3±1.2 vs. 9.5±1.5; concurrent group vs. DM group), Glu (P=0.019, 8.62±3.56 vs. 8.54±2.23; concurrent group vs. DM group), Hcy (P=0.031, 17.56±6.36 vs. 11.16±3.28; concurrent group vs. DM group), total cholesterol ([TC); P=0.022, 3.06±0.20 vs. 3.69±0.29; concurrent group vs. DM group), and low-density lipoprotein ([LDL); P=0.037, 2.57±1.02 vs. 3.40±1.17; concurrent group vs. DM group) in disease group (DM group and concurrent group) were higher than those in the control group; however, apoA (P=0.023, 0.95±0.12 vs. 1.10±0.12; concurrent group vs. DM group) in disease group was lower than that in the control group. Furthermore, there were significant differences between the disease and control groups in terms of GA, HbA 1c, Glu, Hcy, TC, LDL, and apoA (P<0.05). Pearson correlation analysis between DM and concurrent groups was performed on the clinical parameters with statistical differences, and GA was highly correlated with HbA 1c and Glu (P<0.01).
Conclusion: High-risk patient screening with high levels of GA, Hcy, and apoA in elderly patients with T2DM can not only improve the symptoms of patients with targeted treatment but also reduce the incidence of CHD by timely intervention, which is of great significance to improve the quality of life of patients.
Research articles
Seyed Reza Hosseini; Zahra Zohani; Ali Bijani MD; Farzan Kheyrkhah; Ali Zabihi
Volume 22, Issue 8 , 2020
Abstract
Background: Falling and chronic diseases are important health issues in elderly people and reduce the quality of life.
Objectives: This study aimed to investigate the relationship between chronic diseases and falling in the elderly people.
Methods: This cross-sectional study came from the first ...
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Background: Falling and chronic diseases are important health issues in elderly people and reduce the quality of life.
Objectives: This study aimed to investigate the relationship between chronic diseases and falling in the elderly people.
Methods: This cross-sectional study came from the first phase of Amirkola Health and Ageing Project (AHAP) that has been done on all elderly people aged 60 and over in Amirkola city in northern part of Iran. Demographic information including chronic diseases were gathered through self-report, observation of prescriptions and consumed drugs by patients and prevalence of falling during 12 months ago was obtained through information form and interview with elderly people.
Results: In this study, 883 men(54.6%) and 733 women(45.3%) were investigated. The average age of individuals was 69.37±7.42 (in men 70±7.7 and in women 69.7±7.00). In this study, 288(17.8%) of eldely people had the experience of falling in the last 12 months. The prevalence of falling was higher in elderly women(P<0.001) and the elderly who lived alone(P=0.01). The prevalence of falling in the elderly had a significant relationship with diseases of osteoporosis(P<0.001), myocardial infarction(P=0.03), fractures(P<0.001), cognitive impairment(P=0.001), headache(P=0.002). In addition, the results of logistic regression showed that the prevalence of falling was related to urinary incontinence(P=0.02), fracture history(P=0.001), hearing loss(P=0.006), and depressive symptoms(P=0.001).
Conclusions: The results of this study indicate a significant prevalence of falling and its direct relation with some chronic diseases. Therefore, it is necessary to ask some questions and care about each referring of the elderly to the health centers.
Research articles
Arezoo Esmailzadeh; shahla Chaichian; Abolfazl Mehdizadehkashi; Kobra Tahermanesh; Samaneh Rokhgireh; Nastaran Khodakarim; Shima Ghafourian; Saeedeh Moslemi; Meisam Akhlaghdoust
Volume 22, Issue 8 , 2020
Abstract
Introduction: Coronavirus disease 2019 (COVID-19), newly emerging in the world as a pandemic disease, can have rare extrapulmonary manifestations. Few studies have reported coagulation disorders, induced by coronavirus; however, hemorrhage is an extremely rare and life-threatening phenomenon in COVID-19.
Case ...
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Introduction: Coronavirus disease 2019 (COVID-19), newly emerging in the world as a pandemic disease, can have rare extrapulmonary manifestations. Few studies have reported coagulation disorders, induced by coronavirus; however, hemorrhage is an extremely rare and life-threatening phenomenon in COVID-19.
Case presentation: Herein, we present a 31-year-old woman referring with vaginal bleeding, melena, skin ecchymosis, mucosal bleeding, melena, hematuria, and hypovolemic shock. At our center, she was diagnosed as a case of severe internal hemorrhage due to ovulation site hemorrhage and underwent emergency surgery, complicated by prolonged international normalized ratio, which could be due to the presence of COVID-19 in the patient, detected by spiral computed tomography.
Conclusions: This case showed the importance of examining COVID-19 in any patients referring to the hospital during the pandemic as well as paying greater attention to the effect of COVID-19 on coagulation disorders in these patients.
Research articles
omid garkaz; Sahar Paryab; Hamid Reza Mehryar; Hamid Reza Khalkhali; Shaker Salari Lak
Volume 22, Issue 8 , 2020
Abstract
Background and aim: Car crashes are among the prevalent incidents seriously threatening public health. This study aimed to assess the survival and quality of hospital care for patients of car accidents in Western Azerbaijan, Iran.
Methods: This cross-sectional study was conducted on 1,697 trauma victims ...
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Background and aim: Car crashes are among the prevalent incidents seriously threatening public health. This study aimed to assess the survival and quality of hospital care for patients of car accidents in Western Azerbaijan, Iran.
Methods: This cross-sectional study was conducted on 1,697 trauma victims admitted to Imam Khomeini hospital in Urmia, Iran, during 2016. The data, including systolic pressure, Glasgow Coma Scale, respiratory rate prior to admittance, severity of injuries based on surgery description, limbs and brain computed tomography scan, and diagnostic ultrasound by an specialist, were collected from medical records. The survival chance of patients was estimated using Trauma and Injury Severity Score (TRISS). To evaluate the quality of hospital service, Z and W statistics were utilized.
Results: Out of 1,697 admitted victims, 1,226 (72.3%) and 471 (27.7%) subjects were male and female, respectively. The patients were within the age range of 15-54 years, including 901 (75%) male and 296 (25%) female subjects. The predominant educational levels were under diploma and illiterate in male and female patients, respectively. The mean values of the Revised Trauma Score for the recovered and deceased patients were 7.75±0.38 and 6.19±1.59, respectively; however, the mean values of the Injury Severity Score for the recovered and deceased patients were 14.57±13.72 and 52.03±27.02, respectively, indicating a statistically significant difference between the two groups. The number of observed mortalities was 69; nevertheless, the expected mortalities were 60 cases. Furthermore, the quantified W and Z statistics were -9 and 0.02, respectively.
Conclusions: The results showed that the observed mortality exceeded the expected morality indicating the low quality of hospital care.
Research articles
youness teymorivand; zahra hooshmandi; mahbubeh setorki; sabrieh amini
Volume 22, Issue 8 , 2020
Abstract
Background: Based on traditional beliefs, Biarum carduchrum (family Araceae) can strengthen the nervous system and prevent from sleep disorder and agitation.
Objectives: This study was performed to investigate the protective effects of the ethyl acetate extract of Biarum carduchrum leaves against pentylenetetrazol ...
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Background: Based on traditional beliefs, Biarum carduchrum (family Araceae) can strengthen the nervous system and prevent from sleep disorder and agitation.
Objectives: This study was performed to investigate the protective effects of the ethyl acetate extract of Biarum carduchrum leaves against pentylenetetrazol (PTZ)-induced seizure in rats.
Methods: The present experimental research was conducted on 50 male Wistar rats in Iran during 2019. The animals were examined in five groups of control, PTZ, intervention (PTZ with 100 and 200 mg/kg ethyl acetate extract for 10 days), diazepam (PTZ, 200 mg/kg extract, and diazepam). The research groups were compared in terms of behaviors. Furthermore, total phenol and flavonoid levels in the extract were determined using high-performance liquid chromatography.
Results: According to the results, the intervention and diazepam groups had a significantly lower number of the whole body, tonic, head, and upper organ seizures (P<0.05), and jumps (P<0.05), compared to the PTZ group. Both doses of the extract also significantly decreased immobility time in tail suspension and secondary latency time and significantly enhanced spatial memory in Morris water maze test (P<0.05). This treatment also significantly reduced the levels of nitric oxide and malondialdehyde in the brain and serum (P<0.05) and showed antioxidant activity (IC50=200 ?g/ml). The extract contained 42.63±0.7494 and 85.16±6.499 µg/mg phenol and flavonoid, respectively. The HPLC analysis also revealed the presence of quercetin (30 ?g/g) in the extract.
Conclusions: Based on the results, Biarum carduchrum extract can be used for depression control and improvement of learning and memory impairments in seizure patients after complementary testing.
