Background: Folic acid fortification implemented mandatorily in many countries has been associated with significant increase in blood folate concentrations and reduction in the prevalence of neural tube defects. However, there are controversial findings on the probability of vitamin B12 deficiency being masked in the population after folic acid fortification. Baseline data on folate and vitamin B12 status are necessary before mandatory flour fortification is implemented. Objectives: To assess dietary intake of folate and vitamin B12 and to determine blood concentrations of folate, vitamin B12 and homocysteine in women of childbearing age as baseline data regarding folic acid fortification in Iran. Methods: A descriptive cross-sectional survey was performed with 579 healthy women as a representative sample of the Golestan province. Fasting blood samples were taken and dietary (24-hour recall), health and sociodemographic data were collected with an interview. Serum concentrations of folate and vitamin B12 were measured with radioimmunoassay, and plasma homocysteine concentrations were assessed by high-performance liquid chromatography with fluorescence detection. Results: Mean serum concentrations of folate and vitamin B12 were 13.6 nmol/l (95% CI 12.8–14.4) and 194.4 pmol/l (95% CI 183.8–205.0), respectively. Inadequate serum folate levels were present in 14.3% of the women and 22.7% had serum vitamin B12 levels below normal. Mean plasma homocysteine concentration was 12.6 µmol/l (95% CI 12.1–13.2) and hyperhomocysteinemia was observed in 38.3% of the women. Mean daily intake of folate and vitamin B12 was 198.3 µg (95% CI 185.4–211.3) and 2.6 µg (95% CI 1.9–3.2), respectively. Folate intake from food was positively correlated with serum folate concentrations (r = 0.084, p < 0.05) and inversely correlated with plasma homocysteine concentrations (r = –0.115, p < 0.01). Conclusions: An insufficient vitamin B12 as well as folate status is present in Iranian women of childbearing age. The final evaluation will be carried out 18 months after flour fortification and the results will be compared with baseline data obtained from the present study in order to show the efficacy and safety of folic acid fortification in Iran.
Background
At the end of December 2019, a novel respiratory infection, initially reported in China, known as COVID‐19 initially reported in China, and later known as COVID‐19, led to a global pandemic. Despite many studies reporting respiratory infections as the primary manifestations of this illness, an increasing number of investigations have focused on the central nervous system (CNS) manifestations in COVID‐19. In this study, we aimed to evaluate the CNS presentations in COVID‐19 patients in an attempt to identify the common CNS features and provide a better overview to tackle this new pandemic.
Methods
In this systematic review and meta‐analysis, we searched PubMed, Web of Science, Ovid, EMBASE, Scopus, and Google Scholar. Included studies were publications that reported the CNS features between 1 January 2020 and 20 April 2020. The data of selected studies were screened and extracted independently by four reviewers. Extracted data analyzed by using STATA statistical software. The study protocol registered with PROSPERO (CRD42020184456).
Results
Of 2,353 retrieved studies, we selected 64 studies with 11,687 patients after screening. Most of the studies were conducted in China (58 studies). The most common CNS symptom of COVID‐19 was headache (8.69%, 95%CI: 6.76%–10.82%), dizziness (5.94%, 95%CI: 3.66%–8.22%), and impaired consciousness (1.90%, 95%CI: 1.0%–2.79%).
Conclusions
The growing number of studies has reported COVID‐19, CNS presentations as remarkable manifestations that happen. Hence, understanding the CNS characteristics of COVID‐19 can help us for better diagnosis and ultimately prevention of worse outcomes.
Objectives:
To investigate the opinions of different groups of people in Iran on their willingness to receive a COVID-19 vaccine.
Methods:
In this cross-sectional study, we surveyed a sample (based on consecutive referrals) of five groups of people in late 2020: a group of the general population from Shiraz (without a history of any chronic medical or psychiatric problems), patients with epilepsy, patients with diabetes mellitus (DM), patients with cardiac problems, and patients with psychiatric problems. The survey included four general questions and three COVID-19 specific questions.
Results:
582 people participated. In Total, 66 (11.3%) people expressed that they were not willing to receive a COVID-19 vaccine. Psychiatric disorders (OR: 3.15; 95% CI: 1.31-7.60; p = 0.006) and male sex (OR: 2.10; 95% CI: 1.23-3.58; p = 0.010) were significantly associated with COVID-19 vaccine hesitancy.
Conclusion:
Vaccine hesitancy is a global issue. Patients with psychiatric disorders had the highest rate of vaccine hesitancy. Previous studies have shown that depression and anxiety are associated with a reduced adherence to the recommended medical advices. Why male sex is associated with vaccine hesitancy is not clear. Researchers should investigate the rates and the factors affecting the vaccine hesitancy in their corresponding communities.
The association between renal artery stenosis (RAS) and other atherosclerotic diseases (particularly coronary artery diseases) is well known. In general, the risk factors for atherosclerosis have been clarified, but whether these risk factors operate equally in all forms of atherosclerotic diseases is not known. The aim of this study was to describe the prevalence of RAS in patients with established coronary artery diseases and then to define the most important risk factors that may help to predict the RAS in this population. In this cross-sectional study, 146 patients with established coronary artery stenosis by angiography simultaneously underwent renal angiography; RAS>50% was considered significant. We found that 25.3% of patients with coronary artery diseases had RAS. The prevalence of significant stenosis was 17.1%. Females were more vulnerable to this disorder than males (47.1% vs. 13.7%, P = 0.001). There was no relationship between the severity and number of stenosed coronary arteries and those of stenosed renal arteries (P = 0.716). Multi-variate logistic regression analysis revealed that among the risk factors for atherosclerosis, female sex (P = 0.001), duration of hypertension (P = 0.032), age (P = 0.046) and serum creatinine (P = 0.018) were strong predictors of the presence of RAS. We concluded that RAS is a common finding in patients with coronary artery disease. We suggest that all older females with deteriorating renal function and long-standing hypertension should be carefully evaluated for early detection of the RAS.
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