Most of the patients with psoriasis had vitamin D deficiency, which may have contributed to the evolution of their psoriasis. However, considering the high prevalence of vitamin D deficiency in Iran, no difference was noted between the psoriatic patients and the controls.

Introduction. COVID-19, an epidemic of coronavirus infection, has become a major global threat. The coronavirus mainly targets the human respiratory system, followed by cytokine storm, and altered immune responses associated with disease progression and adverse outcomes. Sumac and pomegranate juice are rich in bioactive compounds, which potentially have antiviral activities. This study is aimed at investigating the effect of a diet based on the use of sumac and pomegranate juice on the treatment of outpatients with COVID-19. Methods. In this study, 182 outpatients with COVID-19 were randomly divided into two groups receiving a diet containing pomegranate juice and sumac along with standard treatment and the control group (group 2) receiving standard treatment. Results. Consumption of a diet containing pomegranate juice and sumac in outpatients with COVID-19, who were receiving standard-of-care treatment, led to a significant decrease in fever, chills, cough, weakness, smell and taste disorders, shortness of breath, diarrhea, nausea and vomiting, and abdominal pain compared with outpatients with COVID-19 who received only standard treatment. Conclusion. Clinical trials of outpatients have limitations such as patients’ resilience to post-COVID-19 follow-up. However, the use of pomegranate juice and sumac can be efficacious in reducing COVID-19 symptoms. This trial is registered with IRCT20190406043175N3.

Background Public health policies with varying degrees of restriction have been imposed around the world to prevent the spread of coronavirus disease 2019 (COVID-19). In this study, we aimed to evaluate the effects of the implementation of government policies and the Nowruz holidays on the containment of the COVID-19 pandemic in Iran, using an intervention time series analysis. Methods Daily data on COVID-19 cases registered between February 19 and May 2, 2020 were collected from the World Health Organization (WHO)’s website. Using an intervention time series modeling, the effect of two government policies on the number of confirmed cases were evaluated, namely the closing of schools and universities, and the implementation of social distancing measures. Furthermore, the effect of the Nowruz holidays as a non-intervention factor for the spread of COVID-19 was also analyzed. Results The results showed that, after the implementation of the first intervention, i.e., the closing of universities and schools, no statistically significant change was found in the number of new confirmed cases. The Nowruz holidays was followed by a significant increase in new cases (1,872.20; 95% CI, 1,257.60 to 2,476.79; p<0.001)), while the implementation of social distancing measures was followed by a significant decrease in such cases (2,182.80; 95% CI, 1,556.56 to 2,809.04; p<0.001). Conclusion The Nowruz holidays and the implementation of social distancing measures in Iran were related to a significant increase and decrease in COVID-19 cases, respectively. These results highlight the necessity of measuring the effect of health and social interventions for their future implementations.

Aim: Stroke is the third prevalent cause of disability worldwide. This study aimed to evaluate the role of Dorema ammoniacum and acupuncture in the management of patients with stroke.Methods: In this randomized controlled clinical trial, patients with a recent ischemic stroke (within the first month of stroke) were investigated. The patients were divided into three groups. The first group was managed by acupuncture, while the second group received 1 g of Dorema ammoniacum (two 500 mg capsules per day) from ammoniacum gum. The two intervention groups also received standard treatment with routine medical therapy and physiotherapy. The final group was the control, which only received conventional treatment and physiotherapy. The patients were evaluated immediately before the interventions, and one month after the interventions, using the Modified Rankin Scale (mRS) and Modified National Institutes of Health Stroke Scale (mNIHSS).Results: There was a significant difference in the mean score of mNIHSS at the beginning and end of the study in all of the three studied groups (P<0.001). There were significant pre-treatment/post-treatment differences between the groups (P<0.001). After controlling for the effect of mNIHSS score at the beginning of the study and the follow-up visit, a significant difference was observed between the three groups regarding the mean mNIHSS score post-intervention (P<0.001). The results of the post-hoc test indicated a significant difference between the acupuncture and control groups, Dorema ammoniacum and control groups (P<0.001), acupuncture, and Dorema ammoniacum groups (P<0.001); the extent of reduction was greater in the acupuncture group. The mean mNIHSS scores of the acupuncture and Dorema ammoniacum groups were 1.82 and 1.04 lower than the control group's mean score, respectively. There was a significant difference in the mean mRS score at the beginning and end of the study in all three groups (P<0.001). However, the extent of reduction was greater in the acupuncture group.Conclusion: Acupuncture and Dorema ammoniacum may be beneficial if started within the first month of stroke incidence. However, acupuncture can cause a greater reduction in the mNIHSS score of stroke patients. Trial registration: Iranian Registry of Clinical Trials (IRCT20170227032797N2).Registered 5 March 2018 - Retrospectively registered, https://www.irct.ir/trial/25469

Acetaminophen is a frequently used over-the-counter or prescribed medication in the United States. Exposure to acetaminophen can lead to acute liver cytolysis, acute liver failure, acute kidney injury, encephalopathy, and coagulopathy. This retrospective cohort study (1/1/2012 to 12/31/2017) investigated the clinical outcomes of intentional and unintentional acetaminophen exposure using the National Poison Data System data. The frequency of outcomes, chronicity, gender, route of exposure, the reasons for exposure, and treatments as described. Binary logistic regression was used to estimate the prognostic factors and odds ratios (OR) with 95% confidence intervals (CI) for outcomes. This study included 39,022 patients with acetaminophen exposure. Our study demonstrated that the likelihood of developing severe outcomes increased by aging (OR = 1.12, 95% CI: 1.08–1.015) and was lower in females (OR = 0.88, 95% CI: 0.78–0.99). Drowsiness/lethargy (OR = 1.48, 95% CI: 1.22–1.82), agitation (OR = 1.66, 95% CI: 1.11–2.50), coma (OR = 23.95, 95% CI: 17.05–33.64), bradycardia (OR = 2.29, 95% CI: 1.22–4.32), rhabdomyolysis (OR = 8.84, 95% CI: 3.71–21.03), hypothermia (OR = 4.1, 95% CI: 1.77–9.51), and hyperthermia 2.10 (OR = 2.10, 95% CI: 1.04–4.22) were likely associated with major outcomes or death. Treatments included intravenous N-acetylcysteine (61%), oral N-acetylcysteine (10%), vasopressor (1%), hemodialysis (0.7%), fomepizole (0.1%), hemoperfusion (0.03%), and liver transplant (0.1%). In conclusion, it is important to consider clinical presentations of patients with acetaminophen toxicity that result in major outcomes and mortality to treat them effectively.