Publications by authors named "Ali Bijani"

193 Publications

Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019.

JAMA Oncol 2021 Dec 30. Epub 2021 Dec 30.

Department of Computer Science and Engineering, University of Kurdistan Hewler, Erbil, Iraq.

Importance: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden.

Objective: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019.

Evidence Review: The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs).

Findings: In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles.

Conclusions And Relevance: The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.
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http://dx.doi.org/10.1001/jamaoncol.2021.6987DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719276PMC
December 2021

Anticholinergic drug use in elderly people: A population- based study in Iran.

Caspian J Intern Med 2021 ;12(4):593-599

Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Background: Elderly people are in need of several drugs due to physiological changes and multiple chronic diseases. Studies have shown that anticholinergic drugs can cause cognitive impairment, reduced physical activity, and increased mortality in elderly population. Paying attention to the anticholinergic medication use in older adults can prevent the occurrence of adverse events and increase the quality of health care. This study was conducted to quantify exposure to anticholinergic medicines in older people in Amirkola.

Methods: This study is a part of the comprehensive cohort project that was being conducted from 2011 on the case patients of 60 years and above that referred to the Amirkola Health Center. A total of 1532 individuals were included, of whom 54.9% were men. The drug information was obtained by observing the patient's prescription and self-report questionnaires and collected data were analyzed by SPSS software. Exposure to anticholinergic medications was measured using the drug burden index-anticholinergic (DBI-Ach) and the anticholinergic drug scale (ADS).

Results: Among the 1532 elderly people with an average age of 69.21 years, 29% had DBI>0 and 36.3% had ADS>0. Also, there was a significant correlation between DBI and ADS (R=0.758). In addition, there is a significant relationship between sex variable with DBI and ADS (P=0.0001). So, women in comparison with men had higher values of DBI and ADS.

Conclusion: The findings of this study indicate that anticholinergic exposure is relatively high especially in older women, which posed special precautions to avoid inappropriate prescribing in the elderly.
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http://dx.doi.org/10.22088/cjim.12.4.593DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8590416PMC
January 2021

Evaluation of apoptotic effect of crocin, cisplatin, and their combination in human oral squamous cell carcinoma cell line HN5.

Dent Res J (Isfahan) 2021 18;18:70. Epub 2021 Aug 18.

Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Background: Squamous cell carcinoma (SCC) is the most common oral malignancy with high rate of mortality. Cisplatin, as the most effective chemotherapy drug, has side effects. Considering the studies on the use of crocin in saffron in the treatment of various malignancies, this study aimed at investigating the effects of crocin and cisplatin and their combination on SCC and fibroblast cell lines.

Materials And Methods: In this interventional study, HN5 and fibroblast cell lines were treated with different concentrations of crocin (12.5-50 μg/mL) and cisplatin (2, 4, 8, 16, and 32 μg/mL), and the cells were counted after 24, 48, and 72 h by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Data were analyzed with SPSS Version 17, and < 0.05 was considered the level of significance. In the final stage, flow cytometry after 24 h in terms of the pattern of cell death was done.

Results: Both drugs had a toxic effect on malignant cells. One point was the high toxic effect of 8 μg/mL cisplatin not only on cancer cells ( < 0.001) but also on fibroblasts. However, combination with 12.5 μg/mL of crocin had the same effect on HN5 cell line, despite the less toxic effect in fibroblasts in comparison with cisplatin alone ( = 0.012). Apoptosis was the pattern of cell death showed by flow cytometry.

Conclusion: Crocin in high concentrations can have not only significant toxicity in cancer cells but also side effects in healthy tissue. It seems that lower doses of crocin, in combination with cisplatin, besides having anticancer effect, can reduce the toxicity of cisplatin in healthy tissue.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8428283PMC
August 2021

Burden of Transport-Related Injuries in the Eastern Mediterranean Region: A Systematic Analysis for the Global Burden of Disease Study 2017.

Arch Iran Med 2021 07 1;24(7):512-525. Epub 2021 Jul 1.

Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Transport-related injuries (TIs) are a substantial public health concern for all regions of the world. The present study quantified the burden of TIs and deaths in the Eastern Mediterranean region (EMR) in 2017 by sex and age.

Methods: TIs and deaths were estimated by age, sex, country, and year using Cause of Death Ensemble modelling (CODEm) and DisMod-MR 2.1. Disability-adjusted life years (DALYs), which quantify the total burden of years lost due to premature death or disability, were also estimated per 100000 population. All estimates were reported along with their corresponding 95% uncertainty intervals (UIs).

Results: In 2017, there were 5.5 million (UI 4.9-6.2) transport-related incident cases in the EMR - a substantial increase from 1990 (2.8 million; UI 2.5-3.1). The age-standardized incidence rate for the EMR in 2017 was 787 (UI 705.5-876.2) per 100000, which has not changed significantly since 1990 (-0.9%; UI -4.7 to 3). These rates differed remarkably between countries, such that Oman (1303.9; UI 1167.3-1441.5) and Palestine (486.5; UI 434.5-545.9) had the highest and lowest age-standardized incidence rates per 100000, respectively. In 2017, there were 185.3 thousand (UI 170.8-200.6) transport-related fatalities in the EMR - a substantial increase since 1990 (140.4 thousand; UI 118.7-156.9). The age-standardized death rate for the EMR in 2017 was 29.5 (UI 27.1-31.9) per 100000, which was 30.5% lower than that found in 1990 (42.5; UI 36.8-47.3). In 2017, Somalia (54; UI 30-77.4) and Lebanon (7.1; UI 4.8-8.6) had the highest and lowest age-standardized death rates per 100,000, respectively. The age-standardised DALY rate for the EMR in 2017 was 1,528.8 (UI 1412.5-1651.3) per 100000, which was 34.4% lower than that found in 1990 (2,331.3; UI 1,993.1-2,589.9). In 2017, the highest DALY rate was found in Pakistan (3454121; UI 2297890- 4342908) and the lowest was found in Bahrain (8616; UI 7670-9751).

Conclusion: The present study shows that while road traffic has become relatively safer (measured by deaths and DALYs per 100000 population), the number of transport-related fatalities in the EMR is growing and needs to be addressed urgently.
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http://dx.doi.org/10.34172/aim.2021.74DOI Listing
July 2021

Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning.

PLoS Negl Trop Dis 2021 07 28;15(7):e0008824. Epub 2021 Jul 28.

Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Ghana.

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.
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http://dx.doi.org/10.1371/journal.pntd.0008824DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8318275PMC
July 2021

Evaluation of Serum Pentraxin-3 Level in Patients with Acute Myocardial Infarction Compared with Control Group.

Iran J Pathol 2021 9;16(3):243-247. Epub 2021 May 9.

Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Background & Objective: The aim of this study was to measure serum pentraxin 3 (PTX3) in patients with acute myocardial infarction (MI) and compare it with the control group.

Methods: In this case-control study, 60 patients with MI (±ST-segment elevation) were included in the case group , and those with symptoms suspicious for coronary artery disease (CAD) and with no abnormal findings in angiography and troponin I level less than 99th percentile of normal population were included as a control group (=30). Serum PTX3 and troponin I were measured.

Results: In this study, 60 patients including 34 men and 26 women were included in the case group (mean age: 61.4±8.86 years in non-ST-segment elevation myocardial infarction [NSTEMI] subgroup and mean age: 57.9±9.49 years in ST-segment elevation myocardial infarction [STEMI] subgroup), as well as 13 men and 17 women as the control group (mean age: 55.47±10.09 years). PTX3 level was higher in MI cases (1128.4±1205 pg/mL) compared to controls (394.5±170.40 pg/mL) (=0.001). There was no relationship between ejection fraction (EF) and PTX3 level in the MI group. The area under the ROC curve (AUC) of PTX3 in MI was presented by 0.828 (AUC=0.828) (>0.001). We defined three different cutoffs for PTX in this study, in which the cutoff ≥400 pg/mL had the highest sensitivity (92%), and the cutoff ≥700 pg/mL had the highest specificity (97%).

Conclusion: According to the results of this study, PTX3 as an inflammatory marker showed higher level in patients with MI, especially in STEMI cases. Therefore, combined evaluation of troponin I and PTX3 levels would be associated with more accuracy in diagnosis of MI.
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http://dx.doi.org/10.30699/IJP.20201.116962.2268DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298049PMC
May 2021

Cavaterm treatment in high - risk surgical patients.

Caspian J Intern Med 2021 Apr;12(3):336-341

Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Background: The purpose of the study was to evaluate the effectiveness and safety of thermal balloon ablation in women with high anesthetic and surgical risk compared to invulnerable women according to the American Society of Anesthesia (ASA) physical status stratification.

Methods: This report was based on a retrospective cohort study of women with heavy menstrual bleeding (HMB) who were eligible for treatment with Cavaterm plus during 2012-2017. Women were classified as high-risk (HR) or low-risk (LR) cohorts based on ASA physical status stratification. The primary outcome includes amenorrhea in the twelfth months after the treatment. Risk adjustments were performed using regression models.

Results: This research study consisted of 63 women with mean age 44.42±5.48. Mean of body mass index (BMI) in the HR cohort was higher than the LR cohort (31.48±6.22 vs 26.83± 3.51, P=0.005) and results were also similar considering the uterine length (mm) between HR and LR women (58.27±35.70 vs 30.92± 35.30, P=0.01). The primary outcome of treatment after a one-year follow-up in the two groups (HR and LR) was 31 (93.9%) and 15 (78.9%), respectively. After adjusting for known confounders including age, uterine length, parity, dysmenorrheal, the adjusted odds ratio was 0.94 (95% CI, 0.14- 2.5; P= 0.60).

Conclusion: For women with high anesthetic and surgical risks derived from serious underlying co morbidities, endometrial ablation can provide a minimally invasive, safe, and effective therapy for heavy menstrual bleeding.
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http://dx.doi.org/10.22088/cjim.12.3.336DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223040PMC
April 2021

Effect of variability of central venous pressure values to prevent atrial fibrillation after coronary bypass grafting.

Caspian J Intern Med 2021 Apr;12(3):299-306

Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.

Background: Atrial fibrillation is an arrhythmia that results from abnormal depolarization of the atrium. Atrial fibrillation occurs in 5-40% of patients with cardiovascular bypass surgery, usually occurs on 2 to 4 days postoperatively. The aim of this study was Effect of variability of central venous pressure values to prevent atrial fibrillation after coronary bypass grafting.

Methods: The present clinical trial study was performed on 150 patients undergoing cardiac surgery referred to Ayatollah Rohani Hospital of Babol. Patients were divided into 3 groups, with normal range pressure (8 to 12 mmHg), low pressure (less than 8), high pressure (greater than 12) based on central venous pressure measurements. Patients were evaluated every 4 hours to 72 hours for central venous pressure, AF incidence and urine output. Finally, the data are analyzed by spss statistical software.

Results: In this study 79 (52.7%) patients were male and 71 (47.3%) were female. In examining changes in central venous pressure, the time effect also significantly increased central venous pressure. The results of independent t-test showed that the mean of central venous pressure changes in subjects with at day 16, second day at 16, 20, 24, third day at 4, 8, 12, 16, 20 and 24 hours Atrial fibrillation. Significantly more than those without atrialfibrillation (P<0.05).

Conclusion: In the study, central venous pressure changes the effect of time significantly increases the central venous pressure. Individuals with atrial fibrillation also had significantly greater central venous pressure changes than those without atrial fibrillation.
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http://dx.doi.org/10.22088/cjim.12.3.299DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223041PMC
April 2021

Semi-surgical percutaneous dilatational tracheostomy vs. conventional percutaneous dilatational tracheostomy: A prospective randomized trial.

Caspian J Intern Med 2021 Apr;12(3):249-255

Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran.

Background: Percutaneous dilatational tracheostomy (PDT) is a common surgical procedure in the ICU. The present study was conducted to compare semi-surgical percutaneous dilatational tracheostomy (SSPDT) with conventional percutaneous dilatational tracheostomy (CPDT).

Methods: The present randomized clinical trial was conducted on 160 patients hospitalized in the medical intensive care units (ICUs) with an indication for tracheostomy and were systematically divided into two equal groups of 80. In the CPDT group, after a small incision, a 16-gauge needle was blindly inserted into the trachea and the guidewire was placed inside the lumen. A stoma was created by passing a single dilator over the guidewire. In the SSPDT group, a transverse incision (2 cm) was made 1 cm below the cricoid, and the tracheal ring was then fully reached by releasing the subcutaneous tissues using the index figure, and PDT was then performed. The two groups were compared in terms of their tracheostomy complications (including bleeding, pneumothorax, stoma infection and accidental decannulation) and duration of the procedure.

Results: The two groups were homogeneous in terms of age, gender, mean APACHE score (P>0.05). There were no significant differences between the two groups in terms of the mean time from tracheal intubation to tracheostomy (P=0.869). The duration of the procedure was 5.16±1.72 minutes in the SSPDT group and 6.42±1.71 in the CPDT group (P<0.001). The complication rate was 7(8.75%) in the SSPDT group and 16(20%) in the CPDT group (P=0.043).

Conclusion: SSPDT is safer and has fewer complications than CPDT in ICU patients.
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http://dx.doi.org/10.22088/cjim.12.3.249DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223052PMC
April 2021

Association between body fat and bone mineral density in non-obese post-menopausal women over 60 years old.

Caspian J Intern Med 2021 Mar;12(2):200-206

Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Background: Loss of bone mineral density is one of the most important complications of menopause. The results of studies about the relation between body fat and bone mineral density are controversial. The aim of this study was to determine the association between fat mass and bone mineral density on non-obese post-menopausal elderly women.

Methods: This cross-sectional study is a part of the second phase of the Amirkola Health and Ageing Project (AHAP) that has been done on 356 elderly women with BMI of 18.5-30. Bone mineral density (BMD) and total body fat were measured using the Hologic Horizon-WI densitometer. Statistical tests were ANOVA, Pearson's correlation coefficient and multiple linear regression and a p- value less than 0.05 was considered significant.

Results: The mean age of the participants was 70.22±7.34 and the mean age of menopause was 47.68±5.05. Women with highest fat mass had a greater spine, femur and whole-body BMD (p<0.0001). In this study, we observed a direct and positive significant correlation between body fat mass and BMD at spine (r=0.308), femur (r=0.420) and whole body (r=0.312) (p<0.0001). Adjusted linear regression showed positive effect of fat mass on BMD on all three anatomical sites especially in total femur (β=0.254, p<0.0001).

Conclusion: This study showed a positive correlation between fat mass and bone mineral density at all sites in post-menopausal women.
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http://dx.doi.org/10.22088/cjim.12.2.200DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111810PMC
March 2021

Decreased serum testosterone level was not significantly correlated with lipid indices in elderly men.

Caspian J Intern Med 2021 Mar;12(2):135-139

Student Committee Research, Babol University of Medical Sciences, Babol, Iran.

Background: Aging in men causes a gradual decline in endogenous testosterone levels, which may have detrimental effects on their health status. Testosterone deficiency is thought to promote atherosclerosis by modulating lipid metabolism. Therefore, this study was conducted to evaluate the serum testosterone level and its correlation with lipid profile in men aged ≥60 years old.

Methods: All elderly men aged ≥60, residing in Amirkola and participating in a phase of the comprehensive project on "investigating the health status of the elderly in Amirkola" were entered into this descriptive cross-sectional study. After fasting over 12 hours, the venous blood samples were taken. Serum concentration of testosterone was determined using ELISA method. Moreover, HDL-LDL, total cholesterol, triglyceride and fasting blood glucose were measured.

Results: The prevalence of hypogonadism was 91.28% among the 792 participants of this study with a cut-off point of 9.72 nmol/L (95% confidence interval, 93.25-89.31) and the prevalence of severe hypogonadism with a cut-off point of 5.2 nmol/L was reported 71.59% (95% confidence interval, 74.73-68.44%). Based on the results, there was no significant statistical correlation between the serum level of testosterone and triglyceride (r=0.03, P=0.34). Furthermore, there was a negative correlation between testosterone and HDL, which was not statistically significant(r=-0.05, P=0.13). No significant statistical correlation was found between testosterone and LDL (P=0.98). There was a negative correlation between testosterone and cholesterol, which was not statistically significant (r=-0.02, P=0.49).

Conclusion: According to the study results, 91% of men aged ≥60 years old had hypogonadism, no correlation was found between testosterone and lipid indices.
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http://dx.doi.org/10.22088/cjim.12.2.135DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111815PMC
March 2021

Age-specific reference ranges of prostate-specific antigen in the elderly of Amirkola: A population-based study.

Asian J Urol 2021 Apr 7;8(2):183-188. Epub 2020 Mar 7.

Babol University of Medical Sciences, Babol, Iran.

Objective: To determine the age-specific reference ranges of prostate-specific antigen (PSA) in the older men in the city of Amirkola.

Methods: This cross-sectional study is a part of Amirkola Health and Ageing Project (AHAP) which has been conducted as a cohort study since 2011 in Amirkola, a city in northern Iran. The demographic information of all men aged 60 and older were collected through questionnaires and interviews and the PSA measurements were performed using ELISA and Diametra kit. The acquired data were analyzed afterwards.

Results: A number of 837 elderly men with a mean age of 69.99±7.72 years participated in this study. The serum PSA level (95th percentile) was determined to be 0.9 (0-4.89) ng/mL in the age group of 60-64 years, 1.1 (0-4.88) ng/mL in the age group of 65-69 years, 0.93 (0-9.01) ng/mL in the age group of 70-74 years, 1.3 (0-7.95) ng/mL in the age group of 75-79 years, 1.9 (0-11.98 ng/mL) in the age group of 80-84 years, and 1.45 (0-33.17) ng/mL in the 85 and older group. The serum PSA level was significantly correlated with age (=0.000).

Conclusion: This study indicated that there is a direct correlation between the age and serum PSA levels. The use of age-specific reference range could guide clinicians on the incidence of prostate cancer in this population and perhaps reduce the number of unnecessary tests in this population group.
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http://dx.doi.org/10.1016/j.ajur.2020.03.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099648PMC
April 2021

C-Reactive Protein as a Prognostic Indicator in COVID-19 Patients.

Interdiscip Perspect Infect Dis 2021 23;2021:5557582. Epub 2021 Apr 23.

Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

While some biomolecules have been explored to identify potential biomarkers for the prognosis of COVID-19 patients, there is no reliable prognostic indicator of the disease progression and severity. We aimed to evaluate the ability of the C-reactive protein (CRP) to predict COVID-19 infection outcome. This retrospective study was conducted on 429 patients diagnosed with COVID-19 between March 30, 2020, and April 30, 2020. The study population was divided into severe ( = 175) and nonsevere cases ( = 254). Data on demographic characteristics, clinical features, and laboratory findings on admission were collected. The proportion of patients with increased CRP levels was significantly higher in severe cases than in nonsevere patients. Analysis of the receiver operating characteristic (ROC) curve found that CRP could be used as an independent factor in predicting the severity of COVID-19. Also, patients with CRP >64.75 mg/L were more likely to have severe complications. In conclusion, CRP serum levels can predict the severity and progression of illness in patients with COVID-19.
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http://dx.doi.org/10.1155/2021/5557582DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083820PMC
April 2021

Serum levels of vitamin D in patients with recurrent aphthous stomatitis.

Dent Med Probl 2021 Jan-Mar;58(1):27-30

Department of Clinical Biochemistry, School of Medicine, Babol University of Medical Sciences, Iran.

Background: Recurrent aphthous stomatitis (RAS) is one of the most common recurrent ulcerations in the oral mucosa, the etiology of which has not been elucidated; the immune system dysfunction may play an important role in the pathogenesis of RAS. The anti-inflammatory and regulatory role of vitamin D in the functioning of the immune system is well-documented.

Objectives: This study aimed to evaluate and compare the serum levels of vitamin D between patients with RAS and healthy controls.

Material And Methods: In this case-control study, 43 patients with minor RAS and 43 healthy controls were included. Two groups were matched in terms of age and sex. Blood samples were obtained from all participants. The serum levels of vitamin D were measured with the use of the enzyme-linked immunosorbent assay (ELISA) in patient and control groups. The data was analyzed using the SPSS for Windows software, v. 17.0, with the independent samples t test and the Mann-Whitney test. A p-value of <0.05 was considered statistically significant.

Results: The mean serum level of vitamin D in the control group was significantly higher than that in the case group (22.59 ±16.06 ng/mL vs 13.19 ±8.19 ng/mL, respectively; p = 0.002).

Conclusions: The serum levels of vitamin D are lower in patients with RAS in comparison with healthy controls.
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http://dx.doi.org/10.17219/dmp/126360DOI Listing
June 2021

Comparison of Bone Formation After Sinus Membrane Lifting Without Graft or Using Bone Substitute "Histologic and Radiographic Evaluation".

J Oral Maxillofac Surg 2021 06 30;79(6):1246-1254. Epub 2020 Dec 30.

Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran. Electronic address:

Purpose: Sinus floor elevation without using autogenous bone graft or bone substitute will eliminate donor site morbidity and reduce the cost and the risk of infection. We evaluated the bone gain after sinus membrane elevation without graft or using bone substitute in the same maxilla. Dental implants were inserted simultaneously as a 1-stage procedure.

Patients And Methods: In a split-mouth design, we conducted a randomized double-blinded clinical trial performing sinus lifts and simultaneous implant insertion in 10 healthy patients (n = 20). On the 1 site, we performed graft-less sinus lift (group 1) and on the other site Cerabone was used as bone substitute (group 2), respectively. The quantity and quality of bone gained in each sinus were evaluated and compared radiologically and histomorphometrically.

Results: After 6 months, the average gain of bone height was 6.21 and 9.58 mm in group 1 and 2, respectively, as measured radiologically (P < .001, P < .001). Histomorphometric examination showed significantly higher thickness of trabeculae and bone formation in group 1 (P = .003 and P = .002). However, the neovascularization was higher, but not significantly (P = .288).

Conclusions: Radiological bone gain was similar in both groups. However, histomorphometric examination showed superior bone formation in graft-less group as compared to the Cerabone group. The blood clot seems to be an adequate filler and excellent medium for bone formation. More studies in split-mouth design are needed to compare different bone substitutes.
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http://dx.doi.org/10.1016/j.joms.2020.12.040DOI Listing
June 2021

Epidemiologic comparison of the first and second waves of coronavirus disease in Babol, North of Iran.

Caspian J Intern Med 2020 ;11(Suppl 1):544-550

Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Background: A few studies compared the epidemiologic features of the first and second waves of coronavirus disease 2019 (COVID-19) outbreak. This research was carried out to compare the 1 and the 2 waves of the epidemics in the northern Iran.

Methods: In this observational research, demographic, clinical and laboratory characteristics of the patients with COVID-19, admitted to four government hospitals affiliated to Babol University of Medical Sciences during the 1 and the 2 waves of COVID-19 epidemics have been compared. The period from May 21, 2020 to September 21, 2020 was considered as the second wave of the epidemics while from February 19, 2020 to May 20, 2020, as the first wave of the outbreak in this region.

Results: Out of 6691 total hospitalized cases, 4374 (65.37%), including 1532 (49.6%) people in the first wave and 2842 (78.9%) in the second wave had RT-PCR test for disease confirmation. Among those who were examined with RT-PCR test, 2322 patients (53.1%) including 728 (31.4%) persons in the first wave and 1594 (68.6%) in the second wave were positive for SARS-CoV-2 RNA. 414 (56.9%) of the confirmed cases in the first wave and 767 (48.1%) in the second wave were males (p<0.001). Gastrointestinal symptoms were more incidental in the second wave of the disease. However, severe respiratory conditions were more common during the first wave (p<0.001). Crude mortality rate was lower in the second wave of the outbreak (p<0.001).

Conclusion: Different epidemiologic characteristics were found in the second wave of COVID-19 outbreak in comparison with the first wave of the epidemics in northerrn Iran.
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http://dx.doi.org/10.22088/cjim.11.0.544DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7780865PMC
January 2020

Efficacy of Application of Plasma Rich in Growth Factors Along with the Tunnel Technique for Treatment of Gingival Recession: a Clinical Trial.

J Dent (Shiraz) 2020 Dec;21(4):275-283

Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Statement Of The Problem: The tunnel technique has shown promising results in treatment of gingival recession. Plasma rich in growth factors (PRGF) is considered effective for soft tissue regeneration since it is a rich source of growth factors.

Purpose: This clinical trial aimed to assess the efficacy of PRGF along with the tunnel technique and connective tissue graft for treatment of gingival recession.

Materials And Method: In this controlled clinical trial, 20 areas around anterior and posterior teeth in 3 patients with gingival recession were bilaterally selected. The tunnel technique was used with and without PRGF in the test and control groups, respectively (10 areas in each group). The keratinized gingival width (KGW), clinical attachment level (CAL), clinical probing depth (PD), cementoenamel junction (CEJ) to mucogingival junction (MGJ) distance, and the esthetic visual analog scale (EVAS) score were evaluated preoperatively and at 6 weeks and 3 months, postoperatively. The gingival recession width (RW) and vertical recession depth (VRD) were assessed preoperatively and at 2 weeks and 3 months, postoperatively. The pain visual analog scale (PVAS) score was measured at 1, 3 and 7 days, post-treatment and the healing index (HI) was measured at 1, 3 and 7 days and 1 month, postoperatively. The root coverage percentage was assessed during 3 months. Paired t-test and repeated measures ANOVA were used for statistical analyses. Value< 0.05 was considered statistically significant.

Results: Significant improvements were noted in all tested parameters in both groups (< 0.05). The mean root coverage percentage after 6 months was 88.68%±20.69% and 78.77%±24.94% in the test and control groups, respectively. None of the tested parameters were significantly different between two groups (> 0.05).

Conclusion: Treatment of gingival recession with the tunnel technique can yield favorable clinical outcome, irrespective of the employment of PRGF.
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http://dx.doi.org/10.30476/DENTJODS.2020.83590.1052DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737924PMC
December 2020

Evaluation of Salivary and Serum Total Antioxidant Capacity and Lipid Peroxidation in Postmenopausal Women.

Int J Dent 2020 17;2020:8860467. Epub 2020 Nov 17.

Oral Health Research Center, Babol University of Medical Sciences, Babol, Iran.

Objective: In menopause, reduction of estrogen hormone affects oxidative stress process in serum. Oxidative stress in saliva plays a significant role in the pathogenesis of oral diseases. The aim of this study was to investigate the total antioxidant capacity and lipid peroxidation in the serum and saliva of premenopausal and postmenopausal women.

Methods: In this case control study, 50 postmenopausal women (case group) and 48 premenopausal women (control group) were selected. The unstimulated whole saliva and serum of the postmenopausal and premenopausal women were collected. The total antioxidant capacity (TAC) of the saliva and serum was measured by ferric reducing antioxidant power (FRAP). Also, malondialdehyde (MDA) was measured by thiobarbituric acid reactive substance (TBARS) method for serum and saliva. Then, the obtained data were analyzed by SPSS 17, whereby Mann-Whitney test and Spearman's correlation test were used. < 0.05 was considered statistically significant.

Results: The postmenopausal group had significantly lower mean serum TAC and higher mean serum MDA than the control group ( < 0 < 001 and < 0.01, respectively). The mean salivary TAC and MDA, however, did not differ significantly between the case and control group ( = 0.64 and = 0.08, respectively).

Conclusion: In postmenopausal women, with elevation of serum MDA and reduction of serum TAC, the extent of serum oxidative stress grows, but MDA and TAC levels of saliva do not change.
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http://dx.doi.org/10.1155/2020/8860467DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7685808PMC
November 2020

Evaluation of the Metal Artifact Caused by Dental Implants in Cone Beam Computed Tomography Images.

Maedica (Bucur) 2020 Jun;15(2):224-229

Oral Health Research Center, Health Research Institute.

The presence of a metal object such as dental implants in the scan field may cause artifacts on the cone-beam computed tomography (CBCT) images, which can reduce the diagnostic quality and accuracy of images. The aim of this in vitro study was to compare the severity of implant-induced metal artifacts on CBCT images. To this end, a dry human mandible and a maxilla were selected, then two Roxolid and two Zirconium fixtures with different diameters were placed in the central incisor and first molar sockets and fixed with dental wax. The mandible and maxilla were placed in the simulated phantom for soft tissue, and the occlusal plane was adjusted parallel to the horizon. Images were taken at standard and high resolutions using two CBCT units. The CBCT gray values were measured in three longitudinal sections of the fixture (cervical, middle and apical) and the contrast noise ratio (CNR) was calculated. The CNR values of images were analyzed based on the fixture material, resolution, jaw, unit parameters and fixture size by using the paired t-test and different fixture sections by one-way ANOVA. Depending on the CBCT unit, the CNR values in Roxolid and Zirconium fixtures are completely different. Under higher exposure parameters, the CNR values of the Roxolid and Zirconium fixtures were significantly higher in the maxilla than mandible. However, the fixture size and longitudinal section type did not have a significant effect on the CNR values. In contrast to the fixture material, scanning parameters and jaw type, differences in the size and longitudinal section of the fixtures had no impact on artifact severity.
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http://dx.doi.org/10.26574/maedica.2020.15.2.224DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7482696PMC
June 2020

The effect of Achillea Millefolium L. on vulvovaginal candidiasis compared with clotrimazole: A randomized controlled trial.

Complement Ther Med 2020 Aug 10;52:102483. Epub 2020 Jun 10.

Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. Electronic address:

Introduction: Vulvovaginal candidiasis is the second most common cause of vulvovaginal infections. The aim of this study is to evaluate the effectiveness of vaginal cream of Achillea millefolium extract in women with vulvovaginal candidiasis in comparison with vaginal clotrimazole.

Materials And Methods: This double-blind randomized clinical trial study was conducted on 80 women diagnosed with vulvovaginal candidiasis clinically and by laboratory test; 40 women received vaginal cream clotrimazole 1 % and 40 received vaginal cream containing the aqueous extract of A. millefolium for 7 days. Clinical and laboratory assessments were performed before and after the intervention. Minimum inhibitory concentration of the extract was evaluated with Broth micro-dilution procedure.

Results: The Dermatology life quality index score showed significant reduction in both groups after treatment, but it was significantly more reduced in control group (p < 0.05). Improvement in vulvar erythema was observed in both groups with no statistically difference (p = 0.1). Vaginal culture was negative in term of Candida in 28(77 %) patients of control group and in 18(53 %) patient of experimental group (p < 0.05). The Minimum inhibitory concentration of the extract was 37.5 mg/mL for the standard strain.

Discussion And Conclusion: Study results showed that vaginal cream containing A. millefolium could reduce the complaints of vulvovaginal candidiasis. But, future studies with a larger sample size and different dosages are recommended to assess the outcomes of this new treatment.
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http://dx.doi.org/10.1016/j.ctim.2020.102483DOI Listing
August 2020

Comparison of anthropometric indices for predicting the risk of metabolic syndrome in older adults.

Rom J Intern Med 2021 Mar 5;59(1):43-49. Epub 2021 Mar 5.

Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

The prevalence of obesity and metabolic syndrome (MetS) is increasing, worldwide. Using a simple, efficient and reliable tool for predicting MetS is an essential approach in preventive health programs. The aim of this study was to compare the different anthropometric indices in predicting metabolic syndrome in older adults. This cross-sectional study is a part of the Amirkola Health and Ageing cohort Project (2011-2016). Of total, 1,488 older people aged 60-92 years were entered to the study. Medical and personal information of participants were collected by a questionnaire. After measuring the height, weight, waist circumference, hip circumference and neck circumference, body mass index, waist to hip ratio, waist to height ratio, abdominal volume index and conicity index were calculated. Independent t-test, chi-square and ROC curve were used to analyze the data. Based on ATPIII-2005 diagnostic criteria, the prevalence of metabolic syndrome was 71.57%.The prevalence in female was higher than male. All of examined anthropometric indices, except neck circumference (p = 0.10), showed a significant difference in people with MetS compared to the individuals without metabolic syndrome (p<0.001). Waist to height ratio showed the largest area under the curve for predicting MetS (0.786; 95% CI: 0.76-0.81) followed by BMI (0.746; 95% CI: 0.71-0.77), AVI (0.745; 95% CI: 0.71-0.77), and waist circumference (0.743; 95% CI: 0.71-0.77). Waist to height ratio was the best predictor of MetS in older adults.
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http://dx.doi.org/10.2478/rjim-2020-0026DOI Listing
March 2021

Estimating global injuries morbidity and mortality: methods and data used in the Global Burden of Disease 2017 study.

Inj Prev 2020 10 24;26(Supp 1):i125-i153. Epub 2020 Aug 24.

Department of Pharmacy, Adigrat University, Adigrat, Ethiopia.

Background: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria.

Methods: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced.

Results: GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes.

Conclusions: GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.
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http://dx.doi.org/10.1136/injuryprev-2019-043531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571362PMC
October 2020

Effectiveness of extracorporeal blood purification (hemoadsorption) in patients with severe coronavirus disease 2019 (COVID-19).

BMC Nephrol 2020 08 20;21(1):356. Epub 2020 Aug 20.

Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Ganjafrooz Street, Babol, Iran.

Background: Extracorporeal blood purification has been proposed as one of the therapeutic approaches in patients with coronavirus infection, because of its beneficial impact on elimination of inflammatory cytokines.

Methods: This controlled trial has been conducted on critically ill COVID-19 patients admitted in the state hospital affiliated to Babol University of Medical Sciences, Iran who received different antiviral and antibacterial drugs, and different modalities of respiratory treatments and did not have positive clinical improvement. No randomization and blindness was considered. All of the participants underwent three sessions of resin-directed hemoperfusion using continuous renal replacement therapy with a mode of continuous venovenous hemofiltration (CVVH).

Results: Five men and five women with a mean age of 57.30 ± 18.07 years have been enrolled in the study; and six of them have improved after the intervention. Peripheral capillary oxygen saturation (SpO2) changed after each session. Mean SpO2 before the three sessions of hemoperfusion was 89.60% ± 3.94% and increased to 92.13% ± 3.28% after them (p < 0.001). Serum IL-6 showed a reduction from 139.70 ± 105.62 to 72.06 ± 65.87 pg/mL (p = 0.073); and c-reactive protein decreased from 136.25 ± 84.39 to 78.25 ± 38.67 mg/L (P = 0.016).

Conclusions: Extracorporeal hemoadsorption could improve the general condition in most of recruited patients with severe coronavirus disease; however, large prospective multicenter trials in carefully selected patients are needed to definitely evaluate the efficacy of hemoperfusion in COVID-19 patients.

Trial Registration: The research protocol has been registered in the website of Iranian Registry of Clinical Trials with the reference number IRCT20150704023055N2 .
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http://dx.doi.org/10.1186/s12882-020-02020-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439633PMC
August 2020

Evaluation of the Level of Salivary sHLA-G in Children Aged 3-5 Years with or without Dental Caries.

Int J Dent 2020 30;2020:8870055. Epub 2020 Jun 30.

Oral Health Research Center, Health Research Institute, Babol University of Medical Science, Babol, Iran.

Methods And Materials: This analytic cross-sectional study was carried out on 83 healthy children aged 3 to 5 years of both genders, who were divided into three groups based on decayed dental surfaces (ds): group 1, caries-free children (CF,  = 29); group 2, children with 1 ≤ ds ≤ 3, 1 ≤ ds ≤ 4, and 1 ≤ ds ≤ 5 for age 3, 4, and 5 years, respectively (ECC,  = 20); and group 3, children with ds ≥ 4, ds ≥ 5, and ds ≥ 6 for age 3, 4, and 5 years, respectively (S-ECC,  = 34). The unstimulated saliva samples were collected, and the salivary sHLA-G concentration was measured by the ELISA kit. The SPSS Statistics v17.0 software and Mann-Whitney, Kruskal-Wallis, chi-square, and Spearman's rank correlation tests were used for statistical analysis. The level of significance was considered at < 0.05.

Results: The mean concentrations of salivary sHLA-G in CF, ECC, and S-ECC groups were 3.18 ± 2.28, 5.64 ± 5.51, and 6.21 ± 6.03 ng/l, respectively ( = 0.047), and the mean salivary sHLA-G level was comparatively higher in children with dental caries than that of the CF group ( = 0.02), but there is no significant difference between ECC and S-ECC groups ( > 0.05). Spearman's rank correlation test showed a weak positive correlation ( = 0.039,  = 0.22), between the level of salivary sHLA-G and dental caries.

Conclusion: The present study provides some preliminary evidences on relationship between sHLA-G and dental caries in children.
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http://dx.doi.org/10.1155/2020/8870055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7346253PMC
June 2020

HBS Ag seroclearance and seroconversion time in Patients with chronic hepatitis B Infection.

Caspian J Intern Med 2020 ;11(2):205-210

Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Background: Hepatitis B Surface antigen (HBsAg) seroclearance and seroconversion (development of antibodies against HBsAg) can increases the survival of Chronic hepatitis B (CHB) patients. The aim of this study was to determine the percentage and timing of HBsAg seroclearance and seroconversion in patients with chronic hepatitis B infection.

Methods: 1026 patients with CHB infection who referred to a private clinic were included. These patients had been followed-up for an average of 15 years. The patients whose HBs Ag was cleared from the blood and remained negative until the end of follow-up were designated as HBs Ag serocleared and the patients whose HBs Ab was positive during follow-upwas designated as HBs Ag seroconverted. The time of seroclearance and seroconversion of patients was recorded. Liver function tests, alpha-fetoprotein (AFP) and Hepatitis B early antigen (HBe Ag) status were extracted from the patients' medical records. Data were analysis with SPSS 17.

Results: The duration of follow-up was from 2 to 410 months and most patients were males (58.2%).The survival rate of HBs Ag positivity after 5, 10 and 15 years were 95.6, 89.4 and 80.7%, and 98, 93.5 and 84.9% of patients had not yet developed anti-HBs antibodies after 5, 10 and 15 years, respectively. Age, gender and taking medication had no effect on HBs Ag clearance from the blood or anti-HBs production.

Conclusion: The HBs Ag seroconversion is a rare occurrence, but the incidence of this may increase with time, age and drug consumption. Though there was no relationship in our patients.
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http://dx.doi.org/10.22088/cjim.11.2.205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265509PMC
January 2020

Predictors of Orthostatic Hypotension in the Elderly: Results from the Amirkola Health and Ageing Project (AHAP) Study.

J Tehran Heart Cent 2019 Oct;14(4):165-170

Children's Non-Communicable Diseases Research Center, Babol University of Medical Sciences, Babol, Iran.

Orthostatic hypotension (OH) in the elderly is an important health challenge that poses a significant burden. We sought to determine the prevalence and correlates of OH in an elderly population-based study. This study was conducted within the framework of the Amirkola Health and Ageing Project (AHAP) on 1,588 elderly individuals aged ≥60 years. The baseline measurement was performed from April 2011 to July 2012. The relationships between OH (dependent variable) and age, sex, diabetes, hypertension, and cognitive status (independent variables) were investigated by logistic regression. The mean age of the participants was 69.37±7.42 years (men: 69.96±7.68 y, women: 68.66±7.02 y). The prevalence of OH was 10.7%: 8.4% in the male and 13.7% in the female patients. In the final model, hypertension (OR=2.4, 95% CI: 1.6-3.7), diabetes (OR=1.3, 95% CI: 1.0-1.9), age (OR=2.9, 95% CI: 1.7-4.8), and female sex (female [OR=1.6, 95% CI: 1.1-2.3]) were significantly correlated with OH. The prevalence of OH in our elderly subjects increased with age. Additionally, the older participants with diabetes and hypertension had a higher likelihood of having this OH.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231680PMC
October 2019

Clinical and laboratory findings from patients with COVID-19 pneumonia in Babol North of Iran: a retrospective cohort study.

Rom J Intern Med 2020 Sep;58(3):161-167

Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran.

Background: In December 2019, China has experienced an outbreak of novel coronavirus disease 2019 (COVID-19). Coronavirus has now spread to all of the continents. We aimed to consider clinical characteristics, laboratory data of COVID-19 that provided more information for the research of this novel virus.

Methods: We performed a retrospective cohort study on the clinical symptoms and laboratory findings of a series of the 100 confirmed patients with COVID-19. These patients were admitted to the hospitals affiliated to Babol University of Medical Sciences (Ayatollah Rohani, Shahid Beheshti and Yahyanejad hospitals) form 25 February 2020 to 12 March 2020.

Results: Nineteen patients died during hospitalization and 81 were discharged. Non-survivor patients had a significantly higher C-reactive protein (CRP) (MD: 46.37, 95% CI: 20.84, 71.90; P = 0.001), white blood cells (WBCs) (MD: 3.10, 95% CI: 1.53, 4.67; P < 0.001) and lower lymphocyte (MD: -8.75, 95% CI: -12.62, -4.87; P < 0.001) compared to survivor patients Data analysis showed that comorbid conditions (aRR: 2.99, 95% CI: 1.09, 8.21, P = 0.034), higher CRP levels (aRR: 1.02, 95% CI: 1.01, 1.03, P = 0.044), and lower lymphocyte (aRR: 0.82, 95% CI: 0.73, 0.93, P = 0.003) were associated with increased risk of death.

Conclusions: Based on our findings, most non-survivors are elderly with comorbidities. Lymphopenia and increased levels of WBCs along with elevated CRP were associated with increased risk of death. Therefore, it is best to be regularly assessed these markers during treatment of COVID-19 patients.
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http://dx.doi.org/10.2478/rjim-2020-0013DOI Listing
September 2020

Global injury morbidity and mortality from 1990 to 2017: results from the Global Burden of Disease Study 2017.

Inj Prev 2020 10 24;26(Supp 1):i96-i114. Epub 2020 Apr 24.

Faculty of Health Sciences - Health Management and Policy, American University of Beirut, Beirut, Lebanon.

Background: Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries.

Methods: We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs).

Findings: In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505).

Interpretation: Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.
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http://dx.doi.org/10.1136/injuryprev-2019-043494DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571366PMC
October 2020

Association of Metabolic Syndrome and Its Components with Survival of Older Adults.

Int J Endocrinol Metab 2020 Jan 28;18(1):e91837. Epub 2020 Jan 28.

Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Background: Metabolic syndrome (MetS) as an important risk factor arising from insulin resistance accompanying abnormal adipose deposition and function has become a major challenge to public health around the world.

Objectives: This research was conducted to evaluate the association of MetS and its components with survival of older adults.

Methods: This prospective study is a part of the Amirkola Health and Ageing Cohort Project (2011 - 2017) conducted among 1562 older adults (aged 60 years and over) living in Amirkola, north of Iran. MetS was defined according to four sets of definition: Iranian definition, International Diabetes Federation (IDF) definition, 2001 Adult Treatment Panel (ATP) III and 2005 Adult Treatment Panel (ATP) III.

Results: Eight hundred sixty-three (55.2%) males and 699 (44.8%) females with a mean age of 69.3 ± 7.4 years were included in the research. The results showed that 71.9%, 74.3%, 68.8% and 66.7% of older adults had MetS based on 2005 ATP III, Iranian, IDF and 2001 ATP III diagnostic criteria, respectively. Only raised fasting plasma glucose (FPG) had a significant association with a five-year survival rate of older adults (FPG ≥ 110mg/dL: adjusted HR: 2.05; 95% CI: 1.51 - 2.78; P < 0.001). Other MetS components did not show any significant associations with survival (P > 0.05). Nevertheless, MetS itself significantly decreased the survival rate of older adults after adjusting age, gender and number of chronic diseases (HR = 1.67; 95% CI: 1.16 - 2.41; P = 0.006).

Conclusions: MetS and one of its components, high FPG, have significant associations with survival of older adults.
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http://dx.doi.org/10.5812/ijem.91837DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144244PMC
January 2020

Global, Regional, and National Burden of Calcific Aortic Valve and Degenerative Mitral Valve Diseases, 1990-2017.

Circulation 2020 05 29;141(21):1670-1680. Epub 2020 Mar 29.

Institute of Family Medicine and Public Health, University of Tartu, Tartumaa, Estonia (M.J.).

Background: Nonrheumatic valvular diseases are common; however, no studies have estimated their global or national burden. As part of the Global Burden of Disease Study 2017, mortality, prevalence, and disability-adjusted life-years (DALYs) for calcific aortic valve disease (CAVD), degenerative mitral valve disease, and other nonrheumatic valvular diseases were estimated for 195 countries and territories from 1990 to 2017.

Methods: Vital registration data, epidemiologic survey data, and administrative hospital data were used to estimate disease burden using the Global Burden of Disease Study modeling framework, which ensures comparability across locations. Geospatial statistical methods were used to estimate disease for all countries, because data on nonrheumatic valvular diseases are extremely limited for some regions of the world, such as Sub-Saharan Africa and South Asia. Results accounted for estimated level of disease severity as well as the estimated availability of valve repair or replacement procedures. DALYs and other measures of health-related burden were generated for both sexes and each 5-year age group, location, and year from 1990 to 2017.

Results: Globally, CAVD and degenerative mitral valve disease caused 102 700 (95% uncertainty interval [UI], 82 700-107 900) and 35 700 (95% UI, 30 500-42 500) deaths, and 12.6 million (95% UI, 11.4 million-13.8 million) and 18.1 million (95% UI, 17.6 million-18.6 million) prevalent cases existed in 2017, respectively. A total of 2.5 million (95% UI, 2.3 million-2.8 million) DALYs were estimated as caused by nonrheumatic valvular diseases globally, representing 0.10% (95% UI, 0.09%-0.11%) of total lost health from all diseases in 2017. The number of DALYs increased for CAVD and degenerative mitral valve disease between 1990 and 2017 by 101% (95% UI, 79%-117%) and 35% (95% UI, 23%-47%), respectively. There is significant geographic variation in the prevalence, mortality rate, and overall burden of these diseases, with highest age-standardized DALY rates of CAVD estimated for high-income countries.

Conclusions: These global and national estimates demonstrate that CAVD and degenerative mitral valve disease are important causes of disease burden among older adults. Efforts to clarify modifiable risk factors and improve access to valve interventions are necessary if progress is to be made toward reducing, and eventually eliminating, the burden of these highly treatable diseases.
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http://dx.doi.org/10.1161/CIRCULATIONAHA.119.043391DOI Listing
May 2020
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