Coronavirus is threatening the global public health as a new and widespread crisis. The researchers must keep in mind that one of the most vulnerable groups to COVID-19 are the people with underlying diseases, especially diabetes.This ecological study aimed to investigate the correlation between diabetes and the epidemiological indices of COVID-19.This ecological study included 144 countries. Their available data consists of the cumulative incidence rate of cases, cumulative incidence rate of death, recovery rate, case fatality rate, and performed tests of COVID-19, and diabetes. To collect the variables, a data set was provided which included the information of 144 countries based on diabetes and COVID-19 indices. Spearman coefficients were used for assess correlation between diabetes and COVID-19 indices. Also, Scatter plots of diabetes for the studied countries were drawn based on cumulative incidence rate of cases, cumulative incidence rate of death, tests, recovery rate, and case fatality rate of COVID-19.The results of this ecological study showed in total countries, there was a weak positive correlation between diabetes and cumulative incidence rate of cases and also cumulative incidence rate of death. Correlation between diabetes with test of COVID-19 was very weak. Scatter plots showed a weak liner correlation between diabetes and cumulative incidence rate of cases, cumulative incidence rate of death and test of COVID-19.In this study, there was a weak positive correlation between diabetes and cumulative incidence rate of cases, cumulative incidence rate of death, and performed test of COVID-19. This disease is an enormous challenge for health policymakers; therefore, it is necessary to develop strategies and practical guidelines specific to each region to take the necessary care, especially for diabetic patients.
Background and aims: Public health policies and programs should be adapted to the level of public trust in the healthcare system, as an indicator of the public support level. Accordingly, the data about public trust level in the healthcare system is considered as a critical requirement for managing public health crises. This study aimed to rapidly assess the public trust in the healthcare system during the COVID-19 epidemic in Iran, as well as to evaluate the effect of socioeconomic status (SES) on this trust. Methods: This cross-sectional and web-based study which was conducted in Iran during the COVID-19 epidemic included adults aged 18-60 years. A probability proportional to size multistage random sampling was applied and performed in 15 provinces of the country. Data on the main sources of information about COVID-19, trust in healthcare system, fear level of COVID-19, and demographics were collected via an electronic questionnaire. Multiple linear regression was applied, and adjusted regression coefficients and 95% confidence intervals (CIs) were estimated. Results: A total of 5250 adults (response rate: 76%) were included in the study. The mean of reported trust scores was 50.3±22.8, and that of fear scores was 72.0±17.8. The highest (65%) and lowest (28%) levels of trust were observed among participants from the lowest and highest SES, respectively. Gender (male) (P=0.006), higher levels of education (P<0.001), higher socio-economic status (P<0.001), and higher fear scores (P<0.001) were independently correlated with the lower level of ⦰ trust in healthcare system. Conclusion: It was found that the public trust in Iran’s healthcare system was not high enough at the time of the COVID-19 epidemic in the country, especially among higher social class population.
One year after the prevalence of the novel coronavirus pandemic, some aspects of the physiopathology, treatment and progression of coronavirus 2019 disease (COVID-19) have remained unknown. Since no comprehensive study on the use of urological medications in patients with COVID-19 has been carried out, this narrative review aimed to focus on clinically important issues about the treatment of COVID-19 and urologic medications regarding efficacy, modifications, side effects and interactions in different urologic diseases. In this review, we provide information about the pharmacotherapeutic approach toward urologic medications in patients with COVID-19 infection. This study provides an overview of medications in benign prostatic hyperplasia, prostate cancer, impotence and sexual dysfunction, urolithiasis, kidney transplantation and hypertension as the most frequent diseases in which the patients are on long-term medications. Also, the effect of urologic drugs on the efficacy of vaccination is briefly discussed.
INTRODUCTIONScheuermann’s kyphosis is a structural deformity of the spine that affects roughly 2.2% of the global population ranging from 0.4 to 10% [1, 2]. Scheuermann’s kyphosis results in progressive thoracic and/or thoracolumbar hyperkyphosis in the spinal structure; consequently, ends in severe back pain in the afflicted population [3]. The structural deformity root in osteonecrosis of vertebral apophyses resulting in wedging of at least three adjacent vertebrae [1]. Another theory for the pathophysiology of this disease is alterations in endochondral ossification [4].Patients with Scheuermann’s kyphosis are classified into typical and atypical. Typical cases have thoracic spine involvement, while atypical Scheuermann’s kyphosis cases have wedging in lumbar or thoracolumbar regions [5, 6]. The management of atypical cases initiate with conservative treatments such as bracing and analgesics, but for thoracolumbar curves greater than 25 to 30 degrees, surgical interventions are indicated, whereas the cutoff value for surgical interventions in thoracic Scheuermann’s kyphosis is curvatures greater than 70 to 75 degrees [7]. However, surgical treatment of atypical Scheuermann’s kyphosis is associated with multiple adverse effects, most importantly, junctional kyphosis [8]. It has been shown that spinal sagittal balance does not change significantly after surgical interventions, and is not correlated with preoperative thoracolumbar kyphosis [9, 10]. In this article, we present a case of atypical Scheuermann’s kyphosis who underwent surgical intervention with anterior release and posterior fusion with a 2-year follow-up and excellent outcome without any complications or adjacent segment disease.
Abstract Background Given that COVID-19 continues to spread worldwide, attempts to restrain the virus and to prevent the effects that critically ill patients with COVID-19 have on healthcare systems, has become a public health priority. This ecological study aimed to investigate the correlation between the Human Development Index (HDI) and the epidemiological indicators of COVID-19, including the cumulative incidence rate of cases, the cumulative incidence rate of death, performed COVID-19 tests per million, recovery rate, and case fatality rate. Methods In this ecological study, a data set was provided, which included the epidemiologic indices of COVID-19, HDI, and its components for each country. Correlation coefficients were used to determine linear correlation. Also, the scatter plots of the HDI for the studied countries based on the epidemiologic indices of COVID-19 were drawn. Results This study showed that HDI and its components had positive correlation with a cumulative incidence rate of cases, the cumulative incidence rate of death, and performed COVID-19 tests ( p < 0.001). HDI and two of its components, including literacy and Gross National Income (GNI) components had negative correlation with case fatality rate (CFR). Also, HDI and two of its components, including literacy and life expectancy components had negative correlation with recovery rate. Conclusion Our study showed that the HDI and its components can affect the epidemiological status of COVID-19. As HDI increased, the cumulative incidence rate of cases, cumulative incidence rate of death, and COVID-19 tests increased as well. As HDI increased, CFR and recovery rate decreased as well. Although the HDI is higher in high-income countries, these countries may have also better reporting and surveillance systems.
Background: Lead toxicity is an environmental disease that has been encountered since ancient times and can present with symptoms such as abdominal pain, constipation, or neurological deficits. This issue accounts for the highest burden among environmental disorders. Objectives: The aim of this study was to assess the prevalence of lead toxicity in patients with abdominal pain in Southern Iran. Methods: In this study, 50 pediatric patients with chronic abdominal pain and 50 healthy individuals were compared in terms of their blood lead levels and underlying demographic information that could contribute to lead toxicity. Results: A total of 100 participants were enrolled in this study, with a mean age of 8.50 ± 2.444 years, 53.0% of whom were male. The mean blood lead levels in the control and case groups were 1.54 ± 0.693 and 2.73 ± 2.547 µg/dL, respectively, with a statistically significant difference (P = 0.002). When cutoff values of 2 µg/dL and 3.5 µg/dL were considered for lead toxicity, the prevalence of lead toxicity was significantly higher in the case group. Environmental and demographic factors did not differ between patients with lead toxicity and those with normal lead levels (P > 0.05). Conclusions: The prevalence of lead toxicity in children complaining of chronic abdominal pain was 12.0% (95% CI: 4.5% - 24.3%). However, more accurate testing of the environment is needed in future studies.
Abstract This study aimed to assess the association between serum zinc level with some inflammatory and immunity factors and the duration of hospitalization and mortality rate in patients diagnosed with Covid-19. In this cross-sectional study, blood samples were taken from polymerase chain reaction (PCR) positive patients. New patients diagnosed with Covid-19, admitted to different public hospital wards, were considered eligible for entering the study. The study was done on 179 hospitalized patients diagnosed with Covid-19. Fourteen patients died during the hospitalization and the in-hospital mortality rate was 7.8%, with 9.1% (13 patients) of patients with serum zinc level less than 70 mcg/dL and 3.4% (1 patient) of patients with zinc levels more than 70 mcg/dL. Higher levels of zinc were significantly associated with a higher and lower level of interferon-gamma (IFN-γ) ( p -value = 0.035) and interleukin (IL)-6 ( p -value = 0.004), respectively. The level of serum zinc did not have a significant association with mortality even after adjusting for confounding factors. The relationship between zinc level and the duration of hospitalization was also not significant. In conclusion, serum zinc level had an association with IL-6 and IFN-γ level, but it did not have any significant association with hospital duration or mortality.
Equity in access to and utilization of health services is a common goal of policy-makers in most countries. The fair allocation of human resources is one of the dimensions of equity, which was evaluated in this study.
Abstract Purpose: after the COVID-19 pandemic has been resolved, the world is encountered with long-term effects of this disease that is now called long-COVID-19. In this study, we aimed to assess the effects of previous severe COVID-19 on right ventricular (RV) function. Methods and Materials: in this study, previously healthy patients who were admitted in intensive care units due to COVID-19 in a one-year period were evaluated using speckle-tracking echocardiography after one year of their resolution. The echocardiographic parameters of the RV were reported and assessed based on the COVID-19 treatment and baseline condition of the patients. Results: Eighty-two patients with a mean age of 46.54±12.098 years old entered the study of whom 46 (56.1%) were male. Based on RV free wall longitudinal strain, RV global longitudinal strain, and RV fractional area change 8 (9.8%), 10 (12.2%), and 10 (12.2%) patients had RV dysfunction in a period of at least six months following their discharge. Nevertheless, 33.3% of the patients had at least one determinant of RV dysfunction. We found that the patients who needed anticoagulants and vasopressors were more likely to develop RV dysfunction. Also, the patients’ condition, especially respiratory rate on admission was a better predictor of future RV dysfunction compared to lab data. Conclusion: COVID-19 can induce subclinical and clinical RV dysfunction persisting for as long as a year after the resolution of infection. Since this abnormality can increase cardiovascular mortality, screening of patients who had been hospitalized due to COVID-19 for RV dysfunction might not be unreasonable.
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