In autoimmune bullous diseases (AIBDs), autoantibodies loosen molecular adhesions in the skin and/or mucosa and lead to blisters and erosions. Immunosuppressive drugs reduce mortality of the AIBD; therefore, patients will have to live longer with comorbidities.This study aims to determine the quality of life of AIBD patients undergoing systemic treatment while investigating the survey's relationship with various factors.In this 2-step cross-sectional study, we initially included 53 consecutive pemphigus patients to investigate reliability and validity of the Persian version of Treatment of Autoimmune Bullous Disease Quality of Life (TABQOL) questionnaire. Then, we conducted the study on 119 AIBD patients, currently under treatment at an AIBD clinic in Iran.The mean TABQOL score for our patients was 13.87 ± 7.51. The highest TABQOL was for epidermolysis bullosa acquisita (24 ± 8.485) followed by pemphigus foliaceus (20.5 ± 14.181) and the lowest for pemphigus vulgaris (13.24 ± 6.54). There was no significant difference between patients' TABQOL scores and their gender, history of rituximab injection, and disease severity scores. We only found a positive correlation between TABQOL and prednisolone dose.Treatments of AIBD considerably impact the quality of life of patients and an impairment in quality of life is correlated to higher doses of prednisolone.
Objective No-apnea questionnaire (NAQ) and STOP-BANG questionnaire (SBQ) are widely used for obstructive sleep apnea (OSA) screening. This investigation aimed to compare the SBQ with the NAQ as an OSA screening tool among commercial drivers.
The lack of an integrated national system prevents the Islamic Republic of Iran from registering and reporting all cases of cutaneous leishmaniasis.To establish a laboratory network for the improvement of diagnosis and surveillance of cutaneous leishmaniasis in endemic areas of the Islamic Republic of Iran using parasitological and molecular methods.This descriptive, cross-sectional, pilot study examined 49 laboratories in the 2 endemic areas for cutaneous leishmaniasis in the Islamic Republic of Iran. Samples were taken for identification of the dominant Leishmania species from individuals with cutaneous leishmaniasis referred to the laboratories and had not travelled to other endemic regions. Statistical analysis was conducted using SPSS version 25.0. Using the primary healthcare laboratory network, we established a 3-level surveillance system. We compared misdiagnosis, new cases, clinical relapses, treatment resistance, and treatment failure before and after establishment of the network.Network implementation reduced relapse of cutaneous leishmaniasis. After the laboratory training, the average misdiagnosis rate decreased from 49.3% to 4.2% for positive microscopic slides and from 31.6% to 12% for negative slides. Correct diagnosis was significantly higher in the study areas after the intervention.Implementation of a cutaneous leishmaniasis laboratory network can enhance diagnosis, unify diagnostic methods and improve patient care.دمج التشخيص المختبري لداء الليشمانيات الجلدي وتقييمه في شبكة مختبرات الرعاية الصحية الأولية.محمد زینالي، مهدي محبعلي، محمد رضا شیرزادي، غلام رضا حسن بور، عاطفه بهکار، محمد مهدي کویا، سیامك ميراب سمیعي، حسین ملك أفضلي.نظرًا إلى عدم وجود نظام وطني متكامل في جمهورية إيران الإسلامية، يتعذر تسجيل جميع حالات داء الليشمانيات الجلدي والإبلاغ عنها.هدفت هذه الدراسة الى إنشاء شبكة مختبرات لتحسين تشخيص داء الليشمانيات الجلدي وترصده في المناطق المستوطنة به في جمهورية إيران الإسلامية باستخدام وسائل التشخيص الطفيلي والجزيئي.فحصت هذه الدراسة التجريبية الوصفية المقطعية 49 مختبرًا في المنطقتين المستوطنتين بداء الليشمانيات الجلدي في جمهورية إيران الإسلامية. وقد أُخذت عينات لتحديد أنواع الليشمانيات السائدة من الأفراد المصابين بداء الليشمانيات الجلدي المُحالين إلى المختبرات ولم يسافروا إلى مناطق مستوطنة أخرى. وأُجري تحليل إحصائي باستخدام الإصدار 25.0 من برنامج SPSS. وباستخدام شبكة مختبرات الرعاية الصحية الأولية، أنشأنا نظام ترصُّد ثلاثي المستويات، وقارنَّا التشخيص الخاطئ، والحالات الجديدة، والانتكاسات السريرية، ومقاومة العلاج، وفشل العلاج، قبل إنشاء الشبكة وبعده.قَلَّل تنفيذ الشبكة من انتكاسات مرضى داء الليشمانيات الجلدي. وبعد التدريب المختبري، انخفض متوسط معدل التشخيص الخاطئ من 49.3٪ إلى 4.2٪ بالنسبة للشرائح المجهرية الإيجابية، ومن 31.6٪ إلى 12٪ بالنسبة للشرائح السلبية. وصار التشخيص الصحيح أعلى كثيرًا في مناطق الدراسة بعد التدخل.يمكن أن يؤدي تنفيذ شبكة لمختبرات داء الليشمانيات الجلدي إلى تعزيز التشخيص وتوحيد طرق التشخيص وتحسين رعاية المرضى.Intégration et évaluation du diagnostic de la leishmaniose cutanée dans le réseau de laboratoires de soins de santé primaires.La République islamique d'Iran ne dispose pas d'un système national intégré permettant d'enregistrer et de signaler tous les cas de leishmaniose cutanée.Mettre en place un réseau de laboratoires afin d'améliorer le diagnostic et la surveillance de la leishmaniose cutanée dans les zones d'endémie en République islamique d'Iran à l'aide de méthodes parasitologiques et moléculaires.La présente étude pilote transversale et descriptive a été menée auprès de 49 laboratoires situés dans les deux zones d'endémie de leishmaniose cutanée en République islamique d'Iran. Dans le but d'identifier les espèces dominantes de Leishmania, des échantillons ont été prélevés auprès de personnes touchées par la maladie qui n'ont pas voyagé vers d'autres régions endémiques. Ces échantillons ont ensuite été envoyés aux laboratoires. Une analyse statistique a été réalisée à l'aide du logiciel SPSS version 25.0. Le recours au réseau de laboratoires de soins de santé primaires nous a permis de mettre en place un système de surveillance à trois niveaux. Nous avons comparé les erreurs de diagnostic, les nouveaux cas, les rechutes cliniques, la résistance au traitement et son échec, avant et après la création du réseau.La mise en œuvre de ce réseau a permis de réduire le nombre de rechutes pour la leishmaniose cutanée. Après la formation en laboratoire, le taux moyen d'erreurs de diagnostic a diminué, passant de 49,3 % à 4,2 % pour les lames microscopiques positives et de 31,6 % à 12 % pour les lames négatives. Le nombre de diagnostics corrects était significativement plus élevé dans les zones étudiées après l'intervention.La mise en place d'un réseau de laboratoires pour la leishmaniose cutanée peut permettre d'améliorer le diagnostic, d'en unifier les méthodes et d'optimiser les soins dispensés aux patients.
Background: Toxoplasma gondii infects nearly one-third of the world's population. Due to the significant side effects of current treatment options, identifying safe and effective therapies seems crucial. Nanoparticles (NPs) are new promising compounds in treating pathogenic organisms. Currently, no research has investigated the effects of zinc oxide NPs (ZnO-NPs) on Toxoplasma parasite. We aimed to investigate the therapeutic efficacy of ZnO-NPs against tachyzoite forms of T. gondii, RH strain in BALB/c mice. Methods: In an experiment with 35 female BALB/c mice infected with T. gondii tachyzoites, colloidal ZnO-NPs at concentrations of 10, 20, and 50 ppm, as well as a 50 ppm ZnO solution and a control group, were orally administered four hours after inoculation and continued daily until the mices’ death. Survival rates were calculated and tachyzoite counts were evaluated in the peritoneal fluids of infected mice. Results: The administration of ZnO-NPs resulted in the reduction of tachyzoite counts in infected mice compared to both the ZnO-treated and control group (P<0.001). Intervention with ZnO-NPs significantly increased the survival time compared to the control group (6.2±0.28 days, P-value <0.05), additionally, the highest dose of ZnO-NPs (50 ppm) showed the highest mice survival time (8.7±0.42 days). Conclusion: ZnO-NPs were effective in decreasing the number of tachyzoites and increasing mice survival time in vivo. Moreover, there were no significant differences in survival time between the untreated control group and the group treated with zinc oxide, suggesting that, bulk ZnO is not significantly effective in comparison with ZnO-NPs.
Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disorder that is diagnosed using clinical signs and symptoms and confirmed via nerve conduction studies (NCSs). While NCS is a semi-invasive procedure, magnetic resonance imaging (MRI) is a non-invasive diagnostic tool that detects macroscopic nerve abnormalities and evaluates a patient's surgical or medication treatment options. This study assessed magnetic resonance neurography (MRN)'s diagnostic and grading value by comparing it to electrodiagnostic studies in patients with CTS and healthy individuals.
Although neurologic involvement and neuroimaging abnormalities have been frequently identified in COVID-19 patients, the underlying factors remain unclear. In this study, we assessed the association of the neurological manifestations and neuroimaging features of hospitalized COVID-19 patients with their clinical, laboratory, and imaging characteristics.This multicenter cross-sectional study was conducted between September 2020 and March 2021 at two large academic hospitals in Tehran, Iran. We used census sampling from medical records to enroll hospitalized patients with a positive COVID-19 Polymerase chain reaction (PCR) test who underwent brain imaging due to presenting any acute neurologic symptom during hospital stay.Of the 4372 hospitalized patients with COVID-19, only 211 met the inclusion criteria (35.5% with severe infection). Central nervous system and psychiatric manifestations were significantly more common in severe cases (p ≤ 0.044). Approximately, 30% had a new abnormality on their neuroimaging, with ischemic (38/63) and hemorrhagic (16/63) insults being the most common. The most frequent reasons that provoked cranial imaging were headache (27%), altered consciousness (25.6%), focal neurologic signs (19.9%), and delirium (18%). Analysis revealed a positive correlation for age, neutrophilia, lymphopenia, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) with the emergence of neuroimaging abnormalities (p ≤ 0.018). In addition, patients with new neuroimaging abnormalities had a significantly higher lung CT score than those without any pathologic findings (11.1 ± 4.8 vs. 5.9 ± 4.8, p < 0.001).Approximately 30% of the study population had various acute neuroimaging findings. The lung CT score, neutrophil count, and age were strong predictors of acute neuroimaging abnormalities in hospitalized COVID-19 patients.
Recent literature suggests that markers of neuroaxonal damage, such as neurofilaments and tau protein, might serve as potential biomarkers for ALS. We conducted this systematic review and meta-analysis study to compare cerebrospinal fluid (CSF) and blood levels of total tau (t-tau), phosphorylated tau (p-tau), amyloid beta peptide 42 (Abeta-42), and neurofilaments in ALS patients and controls. A systematic search of Cochrane Library, PubMed, Embase, and ISI Web of Science was conducted on March 18, 2022, and updated on January 26, 2023. Observational studies that compared the concentrations of neurofilament light chain (NfL), neurofilament heavy chain (NFH), t-tau, p-tau, or Abeta-42 in CSF or peripheral blood of ALS patients and controls were included. Data from relevant studies were independently extracted and screened for quality using a standard tool, by at least two authors. Meta-analysis was conducted when a minimum of 3 studies reported the same biomarker within the same biofluid. A total of 100 studies were eligible for at least one meta-analysis. CSF and blood levels of NfL (standardized mean difference (SMD) [95% CI]; CSF: 1.46 [1.25–1.68]; blood: 1.35 [1.09–1.60]) and NFH (CSF: 1.32 [1.13–1.50], blood: 0.90 [0.58–1.22]) were significantly higher in ALS patients compared with controls. The pooled differences between ALS patients and controls were not significant for CSF t-tau, blood t-tau, and CSF Abeta-42, but CSF p-tau was lower in ALS patients (-0.27 [-0.47- -0.07]). Significantly decreased p-tau/t-tau ratios were found in ALS patients compared with controls (-0.84 [-1.16- -0.53]). Heterogeneity was considerable in most of our meta-analyses. CSF and blood neurofilament levels, as well as the CSF p-tau/t-tau ratio, might be potential candidates for improving ALS diagnosis. Further research is warranted to better understand the underlying mechanisms and the clinical implications of these biomarker alterations.
Abstract High blood pressure is a serious public health concern that significantly increases the risks of cardiovascular and cerebrovascular events. Several studies suggested that sleep disorders have adverse effects on health. The current study aimed to evaluate the dose-response relationship between sleep duration and blood pressure in the Iranian large general population. A total of 9865 participants aged 35-65 were included. Night sleep duration was classified as ≤5 hours, 6-, 7-, 8-, 9- and ≥10-hour sleep duration. The relation between self-reported sleep duration and prevalent hypertension was examined using Logistic regression. Moreover, restricted cubic spline analysis showed the dose-response association between sleep duration and hypertension.The age-adjusted prevalence of hypertension was 16.5%, 24.2%, and 20.5% in men, women, and the total population, respectively. Compared with reference sleep duration (7 hours) in the total population, the multivariate odds ratio (OR) for hypertension was 0.7 (95% CI: 0.55-0.88) for the group with 9-hour sleep duration and 0.9 (95% CI: 0.74-1.09) for the group with ≤5-hour sleep duration. However, there was no significant association between sleep duration and the prevalence of hypertension in the multivariable model. The age-adjusted cubic spline suggested a linear inverse association between sleep duration and prevalence of hypertension among men and the total population and a non-linear association among women. In conclusion, a 9-hour sleep duration has a negative association with prevalent hypertension. Moreover, an inverse linear association was found between night sleep duration and prevalent hypertension in the total population.
'%3e%3cg id='e'%3e%3cg id='c' fill='none' stroke='%23fff' stroke-width='2'%3e%3cpath id='b' d='M0 1h26M1 10V5h8v4h8V5h-5M4 9h2m20 0h-5V5h8m0-5v9h8V0m-4 0v9' transform='scale(1.4)'/%3e%3cpath id='a' d='M0 7h9m1 0h9' transform='scale(2.8)'/%3e%3cuse xlink:href='%23a' y='120'/%3e%3cuse xlink:href='%23b' y='145.2'/%3e%3c/g%3e%3cg id='d'%3e%3cuse xlink:href='%23c' x='56'/%3e%3cuse xlink:href='%23c' x='112'/%3e%3cuse xlink:href='%23c' x='168'/%3e%3c/g%3e%3c/g%3e%3cuse xlink:href='%23d' x='168'/%3e%3cuse xlink:href='%23e' x='392'/%3e%3c/g%3e%3cg fill='%23da0000' transform='matrix(45 0 0 45 315 180)'%3e%3cg id='f'%3e%3cpath d='M-.548.836A.912.912 0 0 0 .329-.722 1 1 0 0 1-.548.836'/%3e%3cpath d='M.618.661A.764.764 0 0 0 .422-.74 1 1 0 0 1 .618.661M0 1l-.05-1L0-.787a.31.31 0 0 0 .118.099V-.1l-.04.993zM-.02-.85 0-.831a.144.144 0 0 0 .252-.137A.136.136 0 0 1 0-.925'/%3e%3c/g%3e%3cuse xlink:href='%23f' transform='scale(-1 1)'/%3e%3c/g%3e%3c/svg%3e)
