Hepatitis B virus (HBV) infection is a public health problem as a cause of liver diseases including hepatocellular carcinoma and cirrhosis. It is estimated that 350 million people live with chronic infection and about one million people die every year from complication of this chronic disease in the world. So far, ten HBV genotypes (A-J) has been identified which show a geographical distribution. Throughout the world, carrier variability rate for hepatitis B infection is estimated to be 0.1% to 20%, with regions classified as having low endemicity (<2%), intermediate endemicity (2-7%) and high endemicity (>8%). The prevalence of hepatitis B infection is estimated at 2 to 7 percent In Iran. After HBV vaccination program the prevalence of hepatitis B infection has been reported less than 2%, so Iran can be considered one of the countries with low HBV infection endemicity. In Iran several studies were shown that the only genotype of HBV(100%)was found genotype D as the prominent type in some provinces, but some studies reported genotype B(5%)as well as genotype D(95%).The distribution of HBV genotypes may guide us in determining disease burden, prognosis and antiviral responses. So, it is important to know the epidemiologically of HBV genotyping as well.
Objectives This study aims to investigate the effect of Famotidine on the recovery process of COVID-19 patients. Trial design This phase III randomized clinical trial was designed with two parallel arms, placebo-controlled, single-blind, and concealed allocation. Participants All COVID-19 patients admitted to Shahid Mohammadi Hospital in Bandar Abbas whose PCR test results are positive for SARS-Cov-2 and sign the written consent of the study are included in the study and immunocompromised patients, end-stage renal disease, moderate renal failure (clearance Creatinine 30 to 50 ml/min) or stage 4 severe chronic kidney disease or need for dialysis (creatinine clearance lesser than 30 ml/min), history of liver disease, hepatitis C infection or alcoholism, Glucose 6 phosphate dehydrogenase deficiency(G6PD), the ratio of Alanine transaminase to Aspartate transaminase 5 times above the normal limit, history or evidence of long QT segment on Electrocardiogram, psoriasis or porphyria, pregnancy, use of oral contraceptives, Dasatinib, Neratinib, Ozanimod, Pazopanib, Rilpivirine, Siponimod and/or Tizanidine and allergies to any study drug are excluded. Intervention and comparator Intervention group receives standard pharmacotherapy according to the treatment protocols of the National Committee of COVID-19 and oral famotidine 160 mg (Manufactured by Chemidarou Pharmaceutical Company) four times a day until the day of discharge, for a maximum of fourteen days. Comparator group receives standard drug therapy according to the treatment protocols of the National Committee of COVID-19 and placebo in the same dosage. Main outcomes Patients’ temperature, respiration rate, oxygen saturation, lung infiltration, lactate dehydrogenase and complete blood count were measured at the baseline (before the intervention) and on day 14 after the intervention or on the discharge day. Randomisation The person who has no role in admitting patients and assigning patients to random codes preparing random sequences using online tools and by permuted block randomization method. Eligibility criteria are monitored by the person responsible for admitting patients. Codes in a random sequence are assigned to patients by the treatment team without knowing that each code is in the intervention or comparator group. Patient codes are then matched to randomly generated sequence information for interventions. Blinding (masking) All participants are unaware of which group of this study they are in and after grouping patients in the groups, Patients receive Famotidine in the treatment group and receive a placebo in the control group. The lead researcher, care givers, data collectors, and outcome assessors are aware of the grouping of patients. Numbers to be randomised (sample size) As there is no prior work on this research question, so no assumptions for the sample size calculation could be made. A total of 20 patients participate in this study, which are randomly divided into two groups of 10 as intervention or control groups. Trial status Version 3 of the protocol was approved by the Deputy of Research and Technology and the ethics committee of Hormozgan University of Medical Sciences on August 2, 2020, with the local code 990245, and the recruitment started on August 17, 2020. recruitment ended on August 31, 2020. Since the recruitment ended earlier than expected (the expected recruitment end date was 21/12/2020), we submitted post recruitment but prior to publication of the results. Trial registration The protocol was registered before starting subject recruitment under the title: The effect of Famotidine on the improvement of patients with COVID-19, IRCT20200509047364N2, at Iranian Registry of clinical trials (https://www.irct.ir/trial/49657) on 17 August 2020. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).
Varicella zoster virus (VZV) causes chicken pox as a primary infection following which it becomes latent in neurons. It may then reactivate to cause shingles (herpes zoster). Severity of lesions and VZV pathogenicity are depended on the host's immune response and variant in VZV Dr Athina Myrto ChioniIdentification of VZV seroprevalance rate in general population may lead to develop new health strategic managements such as vaccination. Therefore, we aimed to provide a systematic review of the seroprevalence of VZV infection among Iranian population and estimate age-and gender-specific prevalence of VZV.Keywords "seroprevalence", "varicella zoster virus", and "Iran" were searched in international electronic databases and also in national Persian databases. Twenty two pooled studies among 262 total studies containing (240 published articles, 18 dissertations, and 4 proceedings abstracts) from 1992 to 2014 with total sample size of 7867 individuals were included in the final review.Data was analyzed using random effect method. The heterogeneity was calculated using I-square statistics.The overall IgG seroprevalence rate of VZV infection in general population of Iran was 78.50% (95% CI; 77.74% -79.25%). There was significant heterogeneity among the studies (P<0.0001; I²=99.4%). Furthermore, the relative risk of VZV infection is high in females (80.47%, 95% CI; 79.40% -81.54%) and older adults (95.30%, 95% CI; 94.11% -96.48%).Our results may represent a true background and estimation of VZV infection in Iran and generate the cost-benefits immunization program. Moreover, the ensuing data suggests further attention on disease seroprevalence in order to obtain efficient data for therapeutic intervention targeted against VZV.
Early detection of retroviruses including human T-cell lymphotropic virus and human immunodeficiency virus in the human body is indispensable to prevent retroviral infection propagation and improve clinical treatment. Until now, diverse techniques have been employed for the early detection of viruses. Traditional methods are timeconsuming, resource-intensive, and laborious performing. Therefore, designing and constructing a selective and sensitive diagnosis system to detect serious diseases is highly demanded. Genetic detection with high sensitivity has striking significance for the early detection and remedy of disparate pathogenic diseases. The nucleic acid biosensors are based on the identification of specific DNA sequences in biological samples. Nanotechnology has an important impact on the development of sensitive biosensors. Different kinds of nanomaterials include nanoparticles, nanoclusters, quantum dots, carbon nanotubes, nanocomposites, etc., with different properties have been used to improve the performance of biosensors. Recently, DNA nanobiosensors are developed to provide simple, fast, selective, low-cost, and sensitive detection of infectious diseases. In this paper, the research progresses of nano genosensors for the detection of HIV-1 and HTLV-1 viruses, based on electrochemical, optical, and photoelectrochemical platforms are overviewed.
Background: No specific study has investigated the effect of non-steroidal anti inflammatory drugs (NSAIDs) and especially the effects of Ibuprofen on COVID-19, so far. Objectives: The purpose of this study was to investigate the effect of Ibuprofen on the severity of COVID-19 and mortality caused by the disease. Methods: This study was conducted on 158 patients with COVID-19 who had consumed Ibuprofen, Gelofen, and Novafen for at least one week in the last three months. Patients were divided into three groups (mild, moderate and sever). The relationship among the severity of the disease and the history of ibuprofen consumption, diabetes, history of cardiovascular problems, hypertension, and GFR was investigated. Also, the association between the history of ibuprofen consumption, GFR ≤ 60 mL/min, hypertension, LDH ≥ 500 U/L, lymphocyte count ≤ 1500, and mortality was examined. Results: Our findings showed a significant relationship between the history of Ibuprofen before COVID-19 and the severity of COVID-19, as well as the mortality rate (P value < 0.001, adjusted odd ratio: 2, respectively). This study also showed a significant relationship among the severity of the disease and the history of smoking, diabetes, hypertension, history of cardiovascular diseases, and GFR. In addition, a significant relationship was found among GFR ≤ 60 mL/min mortality, diabetes, LDH ≥ 500 U/L, and lymphocyte count ≤ 1500. Conclusions: Our study showed a significant relationship between the history of the consumption of ibuprofen and its compounds before COVID-19 and the severity of COVID-19, as well as the mortality rate of the patients with this disease, and accordingly, this result can suggest health policies during the epidemic of COVID-19.
Objectives Severe acute respiratory infection (SARI) caused by the SARS-CoV-2 virus may cause lung failure and the need for mechanical ventilation. Infection with SARS-COV-2 can lead to activation of inflammatory factors, increased reactive oxygen species, and cell damage. In addition to mucolytic effects, N-Acetylcysteine has antioxidant effects that we believe can help patients recover. In this study, we evaluate the efficacy of N-Acetylcysteine in patients with severe COVID-19. Trial design This is a prospective, randomized, single-blinded, phase 3 controlled clinical trial with two arms (ratio 1:1) parallel-group design of 40 patients, using the placebo in the control group. Participants All severe COVID-19 patients with at least one of the following five conditions: (respiration rate > 30 per minute), hypoxemia (O2 ≤ saturation, arterial oxygen partial pressure ratio <300), pulmonary infiltration (> 50% of lung area during 24 48 h), Lactate dehydrogenase (LDH) > 245 U / l, Progressive lymphopenia, and admitted to the intensive care unit of Shahid Mohammadi Hospital in Bandar Abbas and have positive PCR test results for SARS-Cov-2 and sign the written consent of the study will be included. Patients will be excluded from the study if they have a history of hypersensitivity to N-Acetylcysteine, pregnancy, or refuse to participate in the study. Intervention and comparator After randomization, participants in the intervention group receive standard of care (SOC) according to the National Committee of COVID-19 plus N-acetylcysteine (EXI-NACE 200mg/mL, in 10mL ampules of saline for parenteral injection (EXIR pharmaceutical company)) at a dose of 300 mg/kg equivalent to 20 gr as a slow single intravenous injection on the first day of hospitalization. In the control group patients receive SOC and placebo ( Sterile water for injection as the same dose). The placebo is identical in appearance to the N-acetylcysteine injection (EXIR pharmaceutical company as well). Main outcomes The primary endpoint for this study is a composite endpoint for the length of hospitalization in the intensive care unit and the patient's clinical condition. These outcomes were measured at the baseline (before the intervention) and on the 14th day after the intervention or on the discharge day. Randomisation Eligible participants (40) will be randomized in two arms in the ratio of 1: 1 (20 per arm) using online web-based tools and by permuted block randomization method. To ensure randomization concealment, random sequence codes are assigned to patients by the treatment team at the time of admission without knowing that each code is in the intervention or comparator group. Blinding (masking) All participants will be informed about participating in the study and the possible side effects of medication and placebo. Patients participating in the study will not be aware of the assignment to the intervention or control group. The principal investigator, health care personnel, data collectors, and those evaluating the outcome are aware of patient grouping. Numbers to be randomised (sample size) A total of 40 patients participate in this study, which are randomly divided; 20 patients in the intervention group will receive SOC and N-acetylcysteine, 20 patients in the control group will receive SOC and placebo. Trial status First version of the protocol was approved by the Deputy of Research and Technology and the ethics committee of Hormozgan University of Medical Sciences on February 14, 2021, with the local code 990573, and the recruitment started on March 2, 2021 and the expected recruitment end date is April 1, 2021. Trial registration The protocol was registered before starting participant recruitment entitled: Evaluation of the efficacy of N-Acetylcysteine in severe COVID-19 patients: a randomized controlled phase III clinical trial, IRCT20200509047364N3, at Iranian Registry of clinical trials on 20 February 2021. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).
Background & Aims of the Study: Cutaneous leishmaniasis (CL) is considered one of the most important human vector-borne diseases in Iran. The current study aimed to determine some epidemiological aspects of cutaneous leishmaniasis in Mazandaran, Northern Iran. Materials and Methods: This descriptive study was conducted using the epidemiological data, including demographic and clinical features collected from 379 patients diagnosed with leishmaniasis in health centers affiliated to the Deputy for Health Center of Mazandaran University of Medical Sciences within 2009-2017. The disease was diagnosed based on clinical information and direct microscopic examination of the samples. Data were analyzed in SPSS software using nonparametric Kruskal-Wallis and Mann-Whitney U tests. Results: A total number of 379 individuals were diagnosed with CL during a 9-year period. Considering the population in Mazandaran, the incidence rate was reported as 1.27 per 100,000 population. It was also revealed that most of the cases of CL (n=279; 73.6%) were males and the majority of patients (n=137; 36.1%) were in the 20-29 age group. In addition, the majority of the ulcers were observed in hand (n=152; 26.7%) and foot (n=129; 22.6%), respectively. Moreover, just one ulcer was spotted in most of the patients (n=143; 37.7%). As the final note, the incidence was at the highest level during autumn in November (n=61; 16.1%). Conclusion: As evidenced by the obtained results, cutaneous leishmaniasis poses a daunting challenge to the public health in Mazandaran. This disease can be attributed to several factors, including agricultural activities, animal husbandry, and frequent national and international holidaymakers' visits to the province. With this background in mind, the results of the currents study could contribute greatly to the effective control of this disease.
Objective: Diabetes mellitus is a chronic illness and adherence to medications is vital to manage the illness. The purpose of this study was to examine the prediction of medication adherence based on personality factors in a group of individuals with type 2 diabetes in Yasuj. Materials and Methods: One hundred twenty individuals with type 2 diabetes who visited health centers were selected for this study through convenience sampling. The participants completed the NEO-Five Factor Inventory and Medication Adherence Rating Scale (MARS). The data were analyzed by mean, standard deviation, and multiple regression analysis using SPSS software. Results: The results showed that among the big-five personality factors, only neuroticisms significantly predicted adherence to medications (β= -0.31, P-value< 0.003). Furthermore, the model explained only 19% of the variance in medication adherence (R2= 0.19, P-value< 0.01). Conclusion: This study indicated that a large proportion of patients with type 2 diabetes did not adhere to their medications. This study highlighted that the personality trait of neuroticism was important in predicting medication adherence in patients with type 2 diabetes.
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