Letter to the editor
Immunology
Majid Mardaniyan Ghahfarrokhi; Ebrahim Banitalebi; Mohammad Faramarzi; Mansooreh Ghorbanpoor Dashtaki; Conrad P. Earnest
Abstract
Dear Editor, The prevalence of coronavirus disease 2019 in China and subsequently in most countries of the world has become the most important health problem and has declared a state of emergency in many countries. According to the WHO (April 10, 2020), positive cases have been observed ...
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Dear Editor, The prevalence of coronavirus disease 2019 in China and subsequently in most countries of the world has become the most important health problem and has declared a state of emergency in many countries. According to the WHO (April 10, 2020), positive cases have been observed in all countries of the world, and its prevalence is increasing sharply, as health systems in many countries have announced a pandemic situation. Finally, as of April 10, 2020, 66220 positive cases and 4110 deaths have been registered, making Iran one of the most infected countries in the world and having the highest number in the region. Given the lack of available vaccines and essential remedies for the virus, numerous articles have been written on providing important scientific information on the virus. Key questions about the modes and mechanisms of transmission, incubation period, level of risk, and effective treatment are still under discussion. Due to the unprecedented outbreak and the state of emergency, many countries including Iran have adopted safeguards including near-total closing of the cities, flight cancellations, closing the schools for long time, and closing the public places such as sport clubs. On the other hand, given China’s successful experience in controlling the epidemic, measures such as self-quarantine are key to the prevention agenda. However, this disrupts the daily activities of millions of people worldwide, as well as in Iran. It is well known that self-quarantine is naturally associated with reduced levels of daily physical activities. Staying home is accompanied by behaviors such as prolonged lying and sitting, watching TV, and using mobile phone. Concurrently, the likelihood of increasing food and calorie intake in inactive conditions is inevitable. Consequently, a reduction in physical activity, and a decrease in resting energy expenditure accompanied by an increase in calorie intake, could increase the risks associated with sedentarism. Hence, while long-term homestay is clearly recognized as an effective and safe preventive measure regarding the spread of virus, inactive lifestyle can lead to detrimental physiological changes including weight gain and metabolic diseases, as well as psychological changes including depression and aggression that may continue until after the end of the disease. Long-term inactivity, which is generally associated with excessive calorie intake, is the major contributor to overweight, followed by increased systemic inflammation. In the current situation where fear of illness causes stress, the combination of stress, overeating, and increased inactivity can severely affect the immune system. In this regard, Dr. Woods, a pioneer in studies of the effects of exercise on the immune system, has shown that regular exercise exerts many anti-inflammatory effects on the body. He has shown in his studies that exercise improves the immune response to the influenza vaccine. Moreover, in his numerous studies on animals and human subjects, he has displayed that endurance exercise has significant anti-inflammatory effects and strengthens the immune system. Therefore, exercise seems to be safe during the coronavirus outbreak and offers many benefits to us. An important issue in the field of exercise in these conditions is the "exercise intensity". If an inactive person wants to start exercising, it is better to start with a low intensity and increase the intensity of the activity over time, as it has been found that intense exercise can have a negative impact on the immunity system of the inactive person. However, if the active person decides to exercise and has already had regular exercise, he or she can continue the exercise at optimal intensity. According to the research, even a single exercise can affect the immune system, but regular exercise has many more benefits, and cellular and molecular changes begin within seconds to minutes after exercise.10 Therefore, in quarantine conditions, continued physical activity and maintaining optimum levels of physical activity to prevent physical and mental disorders, as well as maintaining optimal immune function, is of the utmost importance, while avoiding this has irreparable consequences. Home-based exercise can be performed easily and safely that improves cardiopulmonary and immune function along with maintaining and improving fitness. Balance exercises, stretching, range of motion, stepping, lifting, and moving up the stairs, chair dips, squats, pushups, and planks are examples of home-based exercises, though not limited to these13. Exercises like tai chi, yoga, dumbbell workout, elastic bands, and physioball exercises, as well as some pilates and aerobic exercises can also be performed easily in small space due to the lack of special equipment. In addition to using sports videos, mobile, and web sports software, there are other effective ways to maintain physical function and mental health during the quarantine. Therefore, the restrictions adopted to prevent the outbreak of the coronavirus epidemic should not limit physical activity or exercise, because exercise and physical activity keep people healthy and improve the health of patients with various diseases. It is recommended that physically active people maintain an optimal level of activity and that sedentary people begin their physical activity and increase it over time. Furthermore, individuals staying at home during the coronavirus pandemic can perform 30 minutes of moderate-intensity or 20 minutes of high-intensity physical activities per day. Reducing sitting time and lying down is also highly recommended. Of course, specific groups such as children, the elderly, and people who have experienced the symptoms of the virus or are susceptible to the disease can also ask the advice of sports and health professionals. Given the serious concerns about the increasing prevalence of coronavirus, preventive measures are strongly recommended. Self-quarantine is an important measure to prevent the spread of this infectious virus. Nonetheless, given that long-term quarantine may lead to more sedentary behaviors, increase the anxiety and depression, and lead to increased health risks, maintaining an optimal level of daily physical activity during the coronavirus pandemic is highly recommended.
Letter to the editor
Social Epidemiology
Mohammad-Rafi Bazrafshan; Hamed Delam
Abstract
Dear Editor, Methods that people use to overcome problems are called coping strategies. The concept of coping was first introduced by Lazarus in 1966. He believed that stress involves three stages. First, there is the initial assessment, which is to observe a risk. The second stage involves ...
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Dear Editor, Methods that people use to overcome problems are called coping strategies. The concept of coping was first introduced by Lazarus in 1966. He believed that stress involves three stages. First, there is the initial assessment, which is to observe a risk. The second stage involves the evaluation, which is the search for an answer in the mind, and the third stage is to find the answer to the problem, which is called a coping strategy.1,2 Numerous studies have examined the causes of dangerous behaviors such as smoking, alcohol consumption, and self-harming behaviors in individuals; however, many people who are exposed to difficult psychological distress do not tend to engage in such dangerous behaviors. These people have abilities that other people do not.3 Therefore, the differences between people who engage in dangerous behaviors and those who do not show such reactions in facing the problems can be traced to the coping methods used by these individuals when faced with difficult psychological conditions. However, if the coping strategies that a person uses to face with problems are effective, it creates a sense of self-control and therefore the person can finally solve the problem or cope with it, and if the strategies are ineffective, it will eventually lead to the use of ineffective coping strategies and sometimes dangerous behaviors.4 In a study on COVID-19 in China, researchers found that many people who confronted with COVID-19 pandemic have experienced high levels of psychological distress and that many people have used negative coping strategies for adapting to this crisis.5 Finally, it can be stated that the occurrence of dangerous behaviors in such critical situations is not a behavior without introduction. Therefore, some of the characteristics of people could be deduced such as their inability to find solutions to the problems, lack of coping strategies to manage stressors, and inflexibility and limitation of the number of solutions provided by them. To conclude, strengthening effective defense mechanisms by mental health professionals can reduce the incidence of such destructive behaviors in community members.
Original Article
Clinical
Mehdi Khazaei; Zainab Eslami Hasan Abadi; Mohammad Keshvari Delavar; Morteza Shamsizadeh
Abstract
Background and aims: Hemodialysis (HD) is considered as the main method of renal replacement therapy (RRT) for end-stage renal disease (ESRD) patients in many countries including Iran. Given the limited number of epidemiological studies in this regard at the provincial level across the country, the ...
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Background and aims: Hemodialysis (HD) is considered as the main method of renal replacement therapy (RRT) for end-stage renal disease (ESRD) patients in many countries including Iran. Given the limited number of epidemiological studies in this regard at the provincial level across the country, the present study aimed to describe the demographic and clinical characteristics of ESRD patients and determine the most important causes of ESRD in Hamadan Province. Methods: This cross-sectional study was conducted on 508 HD patients in Hamadan province in January 2017. The checklist used to gather information comprised of the patient’s demographic and clinical information. The analysis was carried out using descriptive analysis including frequency tables and charts and the chi-square statistic test was used to compare the groups using Stata software, version 12. Results: The prevalence rate of HD treatment was 288.9 per million population (PMP). Further, most under HD patients were married, illiterate, and urban residents. The mean age of patients at the diagnosis was 47.64 ± 15.17 years. Hypertension (37.4%), diabetes (28.74%), and glomerulonephritis (10.63%) were the common causes of ESRD. Eventually, there was a significant difference between ESRD causes according to gender and residency (P < 0.05). Conclusion: In general, the prevalence rate of HD in Hamadan was relatively similar to that of developing countries although it was lower than the national average. Furthermore, hypertension and diabetes were the common causes of ESRD in Hamadan Province. Therefore, preventive strategies should be taken to modify their risk factors.
Original Article
Epidemiology
Elham Rezaee; Fatemeh Heidari; Mohammad Nowrouzi
Abstract
Background and aims: Pediculosis is one of the most common parasitic diseases that affect a wide range of age groups. The prevention of head lice infections promotes the physical and mental health of people in the community. Thus, the aim of this study was to investigate the prevalence of head lice ...
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Background and aims: Pediculosis is one of the most common parasitic diseases that affect a wide range of age groups. The prevention of head lice infections promotes the physical and mental health of people in the community. Thus, the aim of this study was to investigate the prevalence of head lice infections and the factors affecting them in those who referred to health centers in Gerash County from 2011 to 2018. Methods: This descriptive cross-sectional study was conducted on patients suspected with head lice infections in health centers in Gerash. These infections were diagnosed by observing adult lice, nymphs, or nits on the head with the help of a magnifying glass. The collected data were then analyzed using SPSS software, version 22 and P ˂ 0.05 was considered as the significance level. Results: In general, 66 410 patients suspected with head lice were examined, of whom 2,547 cases (3.83%) were reported with confirmed infections including 2395 female (94.03%) and 152 male (5.97%) cases. The highest levels of infections were reported in the age group of 6-10 years while the lowest levels of infections were found in children less than 6 years of age. A significant statistical relationship was observed between head lice and gender, age, season, and the place of residence, and year of infection (P < 0.05). Conclusion: Due to the increasing trend of head lice infections in recent years, pediculosis is still considered a health problem. Therefore, training on personal hygiene, adequate access to health services, and early diagnosis and treatment can play an important role in the prevention and elimination of head lice.
Original Article
Cancer Epidemiology
Rida Salman; Khairallah Amhaz; Ali Hellani; Loubna Tayara; Batoul Mourda
Abstract
Background and aims: Lung cancer is the leading cause of cancer death worldwide. There are no recent data on the lung cancer prevalence in Lebanon, and the available data are based on prediction. Thus, this study aimed to determine the incidence rate of lung cancer during 2014, among patients who were ...
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Background and aims: Lung cancer is the leading cause of cancer death worldwide. There are no recent data on the lung cancer prevalence in Lebanon, and the available data are based on prediction. Thus, this study aimed to determine the incidence rate of lung cancer during 2014, among patients who were newly diagnosed at Lebanese teaching hospitals. In addition, the study attempted to identify the associated risk factors of lung cancer, the most common presenting symptoms at the diagnosis time, and the stage at which the majority of the patients were diagnosed at the targeted population. Methods: A retrospective cross-sectional study was carried out in many teaching hospitals affiliated to the Lebanese University in Lebanon in 2016. Results: The lung cancer incidence was 221.9 per 100 000 in 2014. Most patients aged 60 years and over and as regards gender distribution, the majority of them included men. Further, more than half of the patients had the (COPD) and 97% of patients had symptoms at their presentation. Based on the results, 57.9% of them had stage IV lung cancer, but only 12% were diagnosed at the stage IA. Furthermore, 80.6% and 16.4% of patients had non-small and small cell lung cancer, respectively. Finally, 75.4% and 12.1% of them were treated with chemotherapy and underwent surgery, respectively, while 5.2% of patients had radiotherapy. Conclusion: The findings of our study showed a higher incidence rate of lung cancer since 2008 which was diagnosed more commonly in men and with the patient’s history of COPD. Eventually, the diagnosis was mostly made at a later stage with non-small cell lung cancer that was the most common histology type.
Original Article
Epidemiology
Mahmoud Mobasheri; Soleiman Kheiri; Seifollah Bakhshi; Yadollah Ramezani; Mansour Firouzbakht
Abstract
Background and aims: The World Health Organization has listed Iran as the country with the highest number of driving accidents worldwide. Chaharmahal and Bakhtiari is among the top ten provinces in Iran. The aim of this study was to carry out an epidemiological survey on driving accidents resulting ...
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Background and aims: The World Health Organization has listed Iran as the country with the highest number of driving accidents worldwide. Chaharmahal and Bakhtiari is among the top ten provinces in Iran. The aim of this study was to carry out an epidemiological survey on driving accidents resulting in deaths that were referred to the Forensic Medical Center. Methods: In this cross-sectional study, the data were obtained from the Forensic Medical Center in Shahrekord, the provincial capital, during 2005-2016. Data were analyzed using descriptive statistics and the chi-square test by SPSS. Results: The number of registered accidents causing death was 3001. The highest number of accidents (13.5%) occurred from August 23rd to September 22nd, which equates to the last months of the summer according to the solar calendar. Location wise, the highest number of accidents happened in Shahrekord (58.2%). In addition, men and married people were more involved in accidents compared to women and singles. The age group of 21-25 had the most number of accidents. Further, the main road had the highest percentage of accidents (86.7%) compared to freeways, by-ways, and rural roads. Finally, head trauma 1634 (60.7%) was the most important cause of death in people who were in car accidents. Conclusion: Based on these results, policymakers and planners have to carry out necessary positive interferences and plans in order to reduce the number of factors which increase car accidents. Eventually, accidents are usually caused by multiple elements and this makes it necessary to review and optimize the operational output of responsible organizations and offices and the cooperation between them.
Original Article
Epidemiology
Seyed-Mohammad Omrani; Shahyad Azari-Hamidian
Abstract
Background and aims: Mosquitoes (Diptera: Culicidae) are still a focus of research because of their role in the transmission of diseases and annoying biting behavior. Source reduction is an effective measure to control mosquito populations, which is based on good knowledge of larval habitats. ...
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Background and aims: Mosquitoes (Diptera: Culicidae) are still a focus of research because of their role in the transmission of diseases and annoying biting behavior. Source reduction is an effective measure to control mosquito populations, which is based on good knowledge of larval habitats. This study was conducted to obtain that basic knowledge in Chaharmahal and Bakhtiari province. Methods: This study was carried out in 2011 and 2012. Geographical coordinates, altitude, pH, temperature, and the dissolved oxygen level of larval habitats were recorded by relevant devices, followed by documenting physical attributes by direct observation. In addition, the indices of biodiversity were calculated to analyze the vertical biodiversity of species. Finally, the affinity index was calculated to elucidate species co-occurrence. Results: Eighteen species were recovered from 92 larval habitats. Low- (≤ 1400 m), mid- (1401–2000 m), and high- (≥ 2001 m) altitudes lodged 7, 17, and 14 species, respectively. Further, the indices of the species richness and biodiversity for these altitudinal categories were 0.93, 1.94, and 1.58, as well as 1.54, 2.13, and 1.96, respectively. Larval habitats were mostly natural, temporary, with standing but clear water, muddy substrate, sunlit, and with vegetation. Other physicochemical characteristics and affinity of species were described and discussed as well. Conclusion: To the best of our knowledge, this is the first report of vertical distribution and biodiversity of mosquito larvae in Iran. The relative uniformity of physicochemical characteristics of larval habitats was attributed to prevailing water resources in the studied area and sampling design. The oviposition site selection of gravid mosquitoes is still an unresolved problem which needs further investigations.
Original Article
Virology
Mazaher Khodabandehloo; Pezhman Sharifi
Abstract
Background and aims: Maternal primary and recurrent infection of cytomegalovirus (CMV) may be transmitted to the fetus during pregnancy and may have complications such as death or growth, along with the development retardation of the fetus and infant. The aim of this study was to determine ...
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Background and aims: Maternal primary and recurrent infection of cytomegalovirus (CMV) may be transmitted to the fetus during pregnancy and may have complications such as death or growth, along with the development retardation of the fetus and infant. The aim of this study was to determine the prevalence of immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies against CMV in young women, Sanandaj, Iran. Methods: To this end, 90 women (15-40 years old) referring to a clinical laboratory were randomly selected and announced their informed consent to participate in this cross-sectional study. Demographic information and women’s data were collected, including pregnancy, history of abortion, and history of blood transfusion. Then, women’s sera were measured for CMV IgG and IgM antibodies using the electrochemiluminescence technique. Finally, the data were analyzed by SPSS statistical software. Results: The prevalence of IgG and IgM antibodies against CMV in women was 92.2% (95% CI = 86.5-97.8) and 0%, respectively. In addition, the average CMV IgG antibody level was about 137.52 ± 85.215 SD IU/mL. The results revealed a significant statistical association between IgG antibody and pregnancy (P value = 0.012) while there was no association between CMV IgG antibody and other demographic data. Conclusions: In general, high percentages of women had CMV IgG antibody whereas 7.8% of them were susceptible. They are expected to acquire CMV primary infection, and therefore, the screening of antibodies to CMV is suggested for prenatal care.