Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 11 2021 11 17 629 640 Sohrab Almasi Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Farkhondeh Asadi Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2020 08 31 2021 08 16 COVID-19 has created major health-related, economic, and social challenges in societies, and its high contagion has dramatically altered access to healthcare. COVID-19 management can be improved by the use of telehealth. This study aimed to examine different telehealth technologies in the management of COVID-19 disease in the domains of surveillance, diagnosis, screening, treatment, monitoring, tracking, and follow-up and investigate the challenges to the application of telehealth in COVID-19 management. This scoping review was conducted based on Arksey and O’Malley's framework. Searches were performed in Web of Science, PubMed, and Scopus databases to examine the evidence on the effectiveness of telehealth in COVID-19 management. Eventually, 36 articles were selected based on the inclusion criteria. The majority of these studies (33%) were conducted in China. Most services offered via telehealth focused on surveillance, tracking, and follow-up, in that order. Moreover, the most frequently used technologies were social networks, web-based apps, and mobile apps, respectively. The use of telehealth in COVID-19 disease management plays a key role in surveillance, diagnosis, screening, treatment, monitoring, tracking, and follow-up. https://acta.tums.ac.ir/index.php/acta/article/view/8765

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 11 2021 11 17 641 644 Maryam Babaei Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Zahra Kanannejad Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. AND Department of Allergy and Clinical Immunology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran Soheila Alyasin Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2021 03 13 2021 08 10 Bronchiectasis is a clinical syndrome characterized by chronic cough, sputum production, recurrent respiratory infections, and permanent bronchial dilation. The association between the level of alpha-1 antitrypsin (AAT) and bronchiectasis is controversial. In this study, we aimed to investigate this association in children with idiopathic bronchiectasis. The study was conducted on 20 patients with idiopathic bronchiectasis as the case group (mean age 15.9±2.1) and 20 healthy individuals as the control group (mean age 14.9±2.6). Serum AAT level was measured using nephelometric analysis (g/L). Other criteria including sex, parent consanguinity, number of hospitalizations, age of the first symptom were evaluated in both groups related to AAT level. The mean serum level of AAT in the case and control groups were 1.3±0.29; 1.5±0.59, respectively, with statistical significance (P=0.001). There was a significant difference between the two groups in the AAT level distribution, according to AAT normal range (P=0.01). The case group had a more positive attitude toward consanguinity than the control group (66.7% versus 33.3%; P<0.001). The results showed that 80% of patients had the first symptom of disease under one year of age, 6.6% 1-5 years, 6.6% 5-10 years, and 6.6% in more than ten years old. In the case group, 53.3% had a history of medical hospitalization for one time, 26.7% two times, while 20% of the patients had no medical hospitalization. Decreased AAT serum level and high consanguinity rates may be considered as two risk factors for idiopathic bronchiectasis occurrence in children.   https://acta.tums.ac.ir/index.php/acta/article/view/9233

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 11 2021 11 17 675 680 EN Bahar Saberzadeh-Ardestani Department of Gastroenterology, Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran Majid Sorouri Department of Gastroenterology, Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran Bardia Khosravi Department of Gastroenterology, Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran Ali Reza Sima Department of Gastroenterology, Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran Reza Malekzadeh Department of Gastroenterology, Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran 2020 06 19 2021 09 10 An outbreak of COVID-19 started in December 2019 in the city of Wuhan and is now rapidly spreading across the world. We report two cases of confirmed COVID-19 with pre-existing comorbidities who were discharged from the hospital with a good clinical condition and in concordance with interim discharge protocols. However, they were readmitted and died on the discharge day. Here we discuss the importance of patient demographics in clinical management vs. the resolution of the pulmonary disease alone and raise a question about the impact of comorbidities on discharge protocols. https://acta.tums.ac.ir/index.php/acta/article/view/8551

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 11 2021 11 17 645 648 Farsad Imani Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Khalilollah Aleamin Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Mehrdad Goudarzi Department of Anesthesiology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran Alireza Ebrahim Soltani Department of Anesthesiology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran Fazeleh Majidi Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza Khajavi Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran 2020 09 07 2021 08 09 Continuous body temperature monitoring during anesthesia in children is very important. Hypothermia in children may lead to higher morbidity and mortality. Measurement points to detect the temperature of core body are not simply accessible. In this study we measured the skin temperature over the carotid artery and compared it with the nasopharynx. Totally, 84 children of 2-10 years undergoing elective surgery were selected. Temperature over the carotid artery and nasopharynx was measured during anesthesia. Mean temperature of these points was compared which each other, and the effects of age, sex, and weight change of temperature during anesthesia were evaluated. The mean age of patients was 5.4±2.6 years s. 37% of patients were female, and 63% were male. The mean weight was 20±7 kg. The mean duration of surgery was 60.45±6.65 min. The temperature of the skin and nasopharynx was decreased during surgery as after 60 min, the deference between skin over the carotid artery and the nasopharyngeal area was 1° C. The bodyweight has a significant effect on carotid skin temperature in regression model. Skin temperature over the carotid artery, with a simple correction factor of+1° C, provides a viable noninvasive estimate of nasopharyngeal temperature in children during elective surgery with a general anesthetic. https://acta.tums.ac.ir/index.php/acta/article/view/8779

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 11 2021 11 17 681 683 Saeedeh Hosseini Payambar-Azam Hospital, Hormozgan University of Medical Sciences, Qeshm, Hormozgan, Iran Nakisa Niknejad Department of Pathology, Besat Hospital, Hamedan University of Medical Sciences, Hamedan, Iran Arash Dehghan Department of Pathology, Besat Hospital, Hamedan University of Medical Sciences, Hamedan, Iran Nasim Niknezhad Skin Research Center, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Sorena Hedayati Department of Pathology, Besat Hospital, Hamedan University of Medical Sciences, Hamedan, Iran 2020 08 29 2021 08 09 - Diverticulosis of the appendix, as a rare and incident disorder, mimics acute or chronic appendicitis and is characterized by herniation of the appendiceal mucosa through the muscular wall. Symptom and laboratory data of diverticular disease usually represent chronic inflammation. In this study, a 43-year-old female with a history of right lower quadrant pain and anorexia represented abdominal tenderness and rebound tenderness in the physical examination and normal laboratory tests. Abdominal sonography did not show any evidence of acute appendicitis. The removed appendix was 12 cm in length and had multiple diverticular protrusions along with it. The histologic examination showed diverticulosis without evidence of inflammation. The patient was discharged two days later in optimal clinical condition. Diverticulosis of the appendix often is confused with acute or chronic appendicitis based on similar presenting symptoms and imaging studies. Although surgery is the definitive treatment of both conditions, an appropriate diagnosis of diverticular disease before surgery is very important because of the association of appendiceal diverticular disease with neoplasm and other complications. https://acta.tums.ac.ir/index.php/acta/article/view/8762

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 11 2021 11 17 649 655 Fereshte Keshavarzi Department of Health Administration, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran. AND Department of Health Administration, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Elham Aflaki Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Mehrdad Askarian Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Nahid Hatam Department of Health Administration, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran. 2020 06 02 2021 09 10 Osteoporosis is a disease recognized by bone density reduction and is particularly common among older women, which imposes them to fractures. The evidence shows that if do no serious conflict with this issue, in the far little future, huge costs will be imposed on individuals, families, and the country. In this study, we studied the cost-effectiveness of osteoporosis screening in women over 40 years of age in Shiraz in 2016. This cross-sectional study was performed on 240 persons who were screened and 240 non-screened persons in the bone mineral density ward of Shiraz Namazi Hospital. The costs were identified and from the perspective of the insurer and the payer, which included only direct health care costs. To measure the effectiveness, the use of indicators as quality-adjusted life-years (QALY), the expected cost and effectiveness, and the Incremental cost-effectiveness ratio were calculated. The results showed that non-screening is the best strategy, given that the amount of ICER was obtained at $38484.56 and the threshold. As a result, the non-screening method compared to screening is cost-effective. The relevant authorities and proficients should prevent the progression of disease complications and consequently prevent the increase of the disease cost and improve the quality of life of the patients. https://acta.tums.ac.ir/index.php/acta/article/view/8516

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 11 2021 11 17 684 686 Arvin Barzanji Department of Anesthesiology, Faculty of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran Mahfouz Ghaderi Department of General Surgery, Seyed‑Al‑Shohadaee Hospital, Sanandaj, Iran. Payman Rezagholi Department of Operating Room, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran 2021 04 20 2021 08 11 Spermatic vein thrombosis is a rare event that mostly affects the left vein thrombosis but in our report it had developed on the right one that requires meticulous physical examination for diagnosis. The purpose of this case report is to introduce an adult patient with right spermatic vein thrombosis in a 30-year-old man admitted to the operating room for hernia surgery. Spermatic vein thrombosis is an unexpected finding in the differential diagnosis of acute testicular pain. https://acta.tums.ac.ir/index.php/acta/article/view/9330

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 11 2021 11 17 656 661 Sara Mobarak Clinical Research Development Unit, Taleghani Educational Hospital, Abadan University of Medical Sciences, Abadan, Iran.AND Department of Infectious Disease, School of Medicine, Abadan University of Medical Sciences, Abadan, Iran Asma Mohammadi Clinical Research Development Unit, Valiasr Educational Hospital, Abadan University of Medical Sciences, Abadan, Iran Atefeh Zahedi Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran Saeed Jelvay Clinical Research Development Unit, Valiasr Educational Hospital, Abadan University of this study was to investigate the relationship between ferritin, hepcidin, iron, TIBC, and serum inflammatory markers in renal transplant patients. The cross-sectional descriptive-analytical study was conducted on 60 renal transplant patients referred to Hazrat-Rasool and Imam-Ali clinics and Al-Mahdi Laboratory of Shahrekord selected by convenience sampling method. Serum ferritin, hepcidin, iron, TIBC, and inflammatory markers levels were determined by standard kits by ELISA. Data were analyzed by SPSS software. Serum iron had a significant negative correlation with erythrocyte sedimentation rate (ESR) (r= -0.418, P=0.001) and a negative correlation with C reactive protein (CRP) (r= - 0.243, P=0.061). TIBC had a significantly negative association with ferritin (r= - 0.27, P=0.037). Ferritin, hepcidin, and TIBC were not significantly correlated with inflammatory factors. The results of the study showed no significant relationship between ferritin, hepcidin, and TIBC with inflammatory factors in renal transplant patients. https://acta.tums.ac.ir/index.php/acta/article/view/8916

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 6 2022 07 11 384 384 Hossein Mozhdehipanah Department of Neurology, Bou Ali Sina Hospital, Qazvin University of Medical Sciences, Qazvin, Iran Shirin Mavandadi Department of Neurology, Bou Ali Sina Hospital, Qazvin University of Medical Sciences, Qazvin, Iran Sepideh Paybast Department of Neurology, Neuroscience Research Center, Qom University of Medical Sciences and Health, Qom, Iran 2021 08 16 2021 12 28 Safety monitoring of COVID-19 vaccination is paramount of importance. There are limited reports of Guillain-Barré syndrome (GBS) associated with the COVID-19 vaccination. The present study reported a case of GBS following the first dose of the Oxford-AstraZeneca SARS-CoV-2 vaccine. A 32-year-old man presented a history of progressive descending weakness and autonomic features within a month after receiving the Oxford-AstraZeneca SARS-CoV-2 vaccine. The neurological examination was consistent with acute polyneuropathy. The para-clinical investigations were in favor of acute demyelinating polyneuropathy. The patient was diagnosed with GBS, and IVIG was initiated as an acute treatment, which led to significant clinical recovery. We reported a case of GBS after receiving the Oxford-AstraZeneca vaccine. However, our findings dose not conclude a causal association between GBS and COVID-19 vaccination. https://acta.tums.ac.ir/index.php/acta/article/view/9596

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 6 2022 07 11 350 357 Hanan Hanna Department of Basic Science, Faculty of Physical Therapy, Delta University for Science and Technology, Gamsa, Egypt Amany Salama Department of Nutrition and Food Safety, Faculty of Applied Health Sciences Technology, Pharos University in Alexandria, Alexandria, Egypt 2020 11 07 2021 12 27 Obesity/its comorbidities occasionally exist alone, but actually, this is a dynamic network of cross morbidities that are often regarded as separable entities. Obesity is nowadays viewed as an escalating risk factor for iron deficiency, and various theories have been proposed since then explaining their relation. We aimed to determine the relationship of increased body mass index (BMI) with adiponectin, leptin, and iron profile in a sample of middle-aged and older adults with and without iron deficiency anemia. An observational study was performed among 90 participants classified into three groups. Group І included healthy subjects with normal BMI; as a control. Group II included subjects with increased BMI, and group III included subjects with increased BMI and iron deficiency anemia. After overnight fasting, fasting blood glucose, triglycerides, total cholesterol, iron, total iron-binding capacity, complete blood count, serum leptin, and adiponectin were measured. There were significantly higher mean values of BMI among those with anemia, higher mean values of serum leptin, and significantly lower mean values of adiponectin. A significant positive correlation of serum leptin with BMI and a significant negative correlation of serum leptin with iron in Group III were reported. The adiponectin/leptin ratio of (0.8) was correlated with iron and homeostatic model assessment in Group III, and a ratio of (1.1) was significantly correlated with BMI and hemoglobin level in Group II. This could suggest that interventions aimed at increasing the adiponectin/leptin ratio may help in resolving anemia among obese populations by increasing their serum iron and hemoglobin. https://acta.tums.ac.ir/index.php/acta/article/view/8925

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 6 2022 07 11 358 365 EN Mamak Shariat Maternal, Fetal and Neonatal Health Research Center, Institute of Family Health, Tehran University of Medical Sciences, Tehran, Iran Fariba Asghari Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran Mahmoud Motevasel Arani Department of Islamic Maaref, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Nahid Farrokhzad Maternal, Fetal and Neonatal Health Research Center, Institute of Family Health, Tehran University of Medical Sciences, Tehran, Iran Yasamin Mohammadzadeh Breastfeeding Research Center, Institute of Family Health, Tehran University of Medical Sciences, Tehran, Iran Farahnaz Mohammadi Shahboulaghi Social Determinants of Health Research Center, Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Ameneh Abroun Neonatal Intensive Care Unit, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Sayeh Mirzatavoli Neonatal Intensive Care Unit, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Zohreh Janani Nurse in Neonatal Intensive Care Unit, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Sadat Nayeri Maternal, Fetal and Neonatal Health Research Center, Institute of Family Health, Tehran University of Medical Sciences, Tehran, Iran 2021 05 22 2021 12 10 Advances in medicine and medical technology have presented new moral challenges in terms of the management of extremely preterm infants and newborns with severe anomalies and advanced asphyxia. The aim of the present study was to examine the attitudes of health care providers and parents regarding decisions about the treatment of these neonates. The attitude of the Shia clerics is assessed in this study as well. In this qualitative content analysis research, data were collected through semi-structured interviews and focus group discussions (FGDs) with 98 participants, including physicians, nurse practitioners, medical ethicists, Shia clerics, and parents. Purposive sampling was employed by selecting those members of the community whom we thought would provide us w