Alireza Sedaghat; Amene Raouf-Rahmati; Katayoun Samadi; Farida Daneshvar Mozaffari; Ahmad Nemati; Benyamin Fazli
Abstract
Introduction: Currently, humankind is facing a COVID-19 pandemic that has spread worldwide. This is the first study conducted during the first phase of the COVID-19 outbreak in Mashhad, Iran, to describe the clinical, therapeutic, and laboratory findings of survivor and non-survivor patients with COVID-19.Methods: ...
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Introduction: Currently, humankind is facing a COVID-19 pandemic that has spread worldwide. This is the first study conducted during the first phase of the COVID-19 outbreak in Mashhad, Iran, to describe the clinical, therapeutic, and laboratory findings of survivor and non-survivor patients with COVID-19.Methods: This retrospective study included a total of 191 confirmed COVID-19 patients aged ≥18 who were admitted to an intensive care unit in the northeast of Iran in 2020. Clinical, therapeutic, and laboratory findings were recruited. The data were analyzed using SPSS software (version 23) through the Mann-Whitney U test, Chi-Square test, independent sample t-test, as well as a single variable and multivariable logistic regression.Results: Out of a total of 191 hospitalized patients, 137 (71.7%) survived and 54 (28.2%) expired. The mean age of non-survived patients was 17 years higher than that of survived patients (P<0.0001). Hypertension, diabetes, and coronary and pulmonary diseases were significantly related to mortality (OR: 3, 2.8, 21.4, and 5.4, respectively; P<0.05). Respiratory rate >24/min, heart rate>125/min, platelet count <100*109/L, creatinine >133 μmol/L, LDH >245 U/L, WBC count >10*109/L, lymphocyte count <0.8*109/L and D-dimer >1 μg/mL were frequently observed in non-survivor patients (P<0.05). Most of the patients had an abnormality on chest radiographs, and bilateral pulmonary infiltration was the dominant chest radiograph abnormality in these patients. Moreover, consolidation and ground-glass opacification were observed more frequently in non-survived patients (P<0.05). More than 57% of severe cases required non-invasive and invasive mechanical ventilation before they died, while it was 1% in survived cases (P<0.05).Conclusion: Older age, previous comorbidities such as diabetes, hypertension, coronary and pulmonary diseases, lymphopenia, leukocytosis, increased respiratory rate, creatinine, LDH, and D-dimer levels were related to a poor prognosis and mortality in patients with SARS-CoV-2 infection.
Maryam Salehian; Nahid Maleki-Saghooni; Fatemeh Zahra karimi
Abstract
Introduction:Child abuse is a global problem that is deeply rooted in the cultural, social, and economic performance of society. It is a behavior that occurs in various forms of physical, mental, emotional, or sexual, which can cause harm to the health, welfare, and education of the child. The present ...
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Introduction:Child abuse is a global problem that is deeply rooted in the cultural, social, and economic performance of society. It is a behavior that occurs in various forms of physical, mental, emotional, or sexual, which can cause harm to the health, welfare, and education of the child. The present study was conducted to estimate the prevalence of child abuse and its related factors in Iran.Methods:In the present systematic review study, to find articles related to the prevalence of child abuse in Iran, valid databases such as Scopus, PubMed, Cochrane, SID, Magiran, IranDoc, and Google Scholar was were searched using the keywords of “child abuse”, “physical abuse” “emotional abuse”,” neglect”, “prevalence” and “Iran”.Results: In this study, 22 articles were analyzed. Based on this review about 4.5%-58.2% of children reported physical abuse, 7.3%-91.6% emotional abuse, and 5.5%-85.3% neglect. Factors associated with child abuse were hyperactivity anxiety and mental status disorder. All studies showed a significant relationship of abuses with education, occupation, addiction, and divorce of parents. Moreover, depression and anxiety of parents and poor parental relationships were related to abuse of children. Conclusion: Child abuse has many negative effects on childish and adolescent health. It seems that child abuse in Iran is in critical condition; therefore, policymakers must take action to solve this problem and prevent it by designing special programs and effective policies in Iran.
Razieh Amirfakhrian; Atieh Yaghobi; Roya Saddat Ghaderi; Seyed Isaac Hashemy; Kiarash Ghazvini
Abstract
Introduction: In recent decades, the inappropriate use of antibiotics and the existence of transferable resistant elements have caused the emergence of multidrug-resistant (MDR) gram-negative organisms. Antimicrobial resistance is becoming one of the major challenges to public health and has caused morbidity ...
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Introduction: In recent decades, the inappropriate use of antibiotics and the existence of transferable resistant elements have caused the emergence of multidrug-resistant (MDR) gram-negative organisms. Antimicrobial resistance is becoming one of the major challenges to public health and has caused morbidity and mortality worldwide. The purpose of this study was the assessment of the prevalence and frequency of colistin resistance among gram-negative bacilli (Enterobacteriaceae, Acinetobacter spp., and Pseudomonas spp.) in Iran and around the world. Methods: For this systematic review and meta-analysis, we searched international and national databases, including PubMed, Google Scholar, SID, and Magiran, from 1998 to 2018 for articles and abstracts describing colistin resistance among gram-negative bacilli. We have included 92 studies that met our inclusion criteria, and the outcomes were combined using a random-effects model to derive the event rate of colistin resistance among gram-negative bacilli. Data were analyzed by the Comprehensive Meta-Analysis Software (V2), and the heterogeneity of the studies was assessed using the I2 index. Results: Out of the 11050 papers identified, 92 studies met the strict inclusion criteria and were finally included. The overall event rate of colistin resistance among gram-negative bacilli (GNB) was about 6.6%, while the event rate of colistin resistance among Acinetobacter spp. (n = 18504) was 2.8% (summary: 95% confidence interval (CI): [0.02, 0.041], P = 0.001, I2 = 70, df (Q) = 36, Q-value = 121.924). The colistin resistance among Pseudomonas spp. (n = 15094) was 3% (95% CI: [0.022, 0.041], P = 0.001, I2 = 68.3, df (Q) = 25, Q-value = 85.648), and the colistin resistance among Enterobacteriaceae spp. (n = 44772) was 0.8% (95% CI: [0.004, 0.014], P = 0.001, I2 = 87.6, df (Q) = 15, Q-value = 71.291). Therefore, the event rate of resistance to colistin among GNB was relatively low (6.6%). Conclusion: The event rate of resistance to colistin among GNB was low. Therefore, this antimicrobial agent can still be administered as a suitable option against GNB that are resistant to other antibiotics such as carbapenems.