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Background: Considering that few studies have investigated the differences in clinical, laboratory, and imaging symptoms of patients with coronavirus disease 2019 (COVID-19) during different peaks of the disease in Iran, the present study compares the patients who were admitted to the COVID-19 departments of Imam Reza Hospital during the first, second, and third peaks of the disease. Methods: In this cross-sectional study, data were collected by reviewing the files of patients with a definite diagnosis of COVID- 19 based on the RT-PCR test in Imam Reza Hospital in Mashhad. The patients were divided into three groups based on the time of admission: The first peak from March 2020 to June 2020, the second peak from July to September 2020, and the third peak from October to December 2020. The variables evaluated in this study included demographic information, clinical signs and symptoms, and laboratory and radiological findings. Descriptive qualitative data were reported using frequency tables, while quantitative descriptive data were reported using measures of central tendency and dispersion. A comparison of qualitative data among the three peaks was conducted using the chi-square test, while for quantitative data, the ANOVA test was used followed by appropriate post-hoc tests. Results: A total of 561 patients with an average age of 58.90 ± 16.80 years were included in the study, of which 336 (59.9%) were male. Regarding underlying diseases, significant differences were found in age (P < 0.001), smoking (P < 0.001), diabetes (P = 0.003), high blood pressure (P < 0.001), asthma (P = 0.025), and ischemic heart disease (P < 0.001). For vital signs, significant differences were observed in heart rate (P < 0.001), respiration rate (P < 0.001), diastolic blood pressure (P = 0.010), and SPO2 (P < 0.001). In clinical characteristics, significant differences were found in fever (P < 0.001), nausea (P = 0.011), vomiting (P = 0.031), headache (P < 0.001), weakness (P < 0.001), and sore throat (P < 0.001). In laboratory characteristics, significant differences were observed in white blood cell (WBC) count (P = 0.024), neutrophil percentage (P < 0.001), lymphocyte percentage (P < 0.001), and C-reactive protein (CRP) (P = 0.001). The CT score values of the patients were significantly different between the three peaks. Patient mortality was significantly different across the three peaks. Less than 15% of hospitalized patients died in the first peak, while over 24% died in the second peak and nearly 40% of inpatients died in the third peak. In our study, the first and third surges and the second and third surges had different mortalities. Conclusions: The third and first peaks had the highest and lowest mortality rates, respectively. Underlying diseases and unstable vital signs were more common in the second and third peaks. Patients in the second peak had significantly higher CT scores compared to the other peaks. [ABSTRACT FROM AUTHOR]

Background & Objective: Incomprehensive studies have examined the therapeutic and side effects of curcumin on the treatment of debilitating diseases, such as Rheumatoid Arthritis (RA). This study aimed to explore the antiinflammatory effects of curcumin on RA. Materials & Methods: This double-blind clinical trial was carried out on 64 RA patients with an erythrocyte sedimentation rate (ESR)-Disease Activity Score (DAS)- 28>2.6. The patients were then randomly divided into two groups of intervention and control. In addition to the routine treatment, the intervention group was treated with 80-mg/day capsules of curcumin (nano-micelles). Further, the patients were followed up for three months, and clinical-laboratory examinations were recorded in this study. Results: There was no significant difference between the intervention and control groups regarding the trends of the disease activity indicators, including DAS-28, disability index, physician assessment, and the number of tender joints (P>0.05). Further, a significant difference was found between the two groups in terms of pain score changes and the number of swollen joints. Additionally, the curcumin-treated subjects obtained lower mean pain and fewer swollen joints, compared to those in the control group (P<0.05). Conclusion: The present study revealed that curcumin had no significant therapeutic effects on reducing the activity of RA; however, no significant side effects were observed on the patients, and it also showed its analgesic effect well. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most frequent malignancy and the leading cause of cancer-related death among women all around the world. In Iran, the mean age of the patients is approximately 10 years younger than that in other countries. We conducted the present study to assess the risk factors of breast cancer among Iranian women in Mashhad. Method: This case-control study was carried out between February 2016 and January 2018 on 460 women (230 cases and 230 controls) in the academic hospitals of Mashhad. The data from our cases and controls were collected and analyzed using SPSS version 18.0 software (SPSS Inc., Chicago, IL, USA). We employed logistic regression models and frequency tables to estimate odds ratio (OR) and to examine the predictive effect of each factor on breast cancer risk. P < 0.05 was considered to be significant. Results: According to multivariate analysis, there was significant associations between breast cancer risk and body mass index (BMI) (Odds ratio (OR), 1.1; 95% Confidence interval (CI), 1.0-1.2), age at menarche (OR, 0.56; 95% CI, 0.47-0.68), menopausal age (OR, 1.1; 95% CI, 1.0-1.1), family history of non-breast malignancies (OR, 7.9; 95% CI, 2.2-21.1), and oral contraception pills (OR, 3.1; 95% CI, 8.34- 1.16). Conclusion: This study revealed that age at menarche, family history of non- breast cancer malignancies, BMI, menopausal age, and oral contraception pills were significantly associated with breast cancer. [ABSTRACT FROM AUTHOR]

Objective: Schizophrenia is a disease with unknown etiology. There is evidence suggesting that oxidative damage occurs in schizophrenia. Oxidative damage may arouse from imbalance between oxidant and anti-oxidant factors in cellular and tissue environment. Although it may not be the primary cause, it can worsen the disease and may be a reason of poor response to therapy in these patients. The present study aimed at evaluating the pro-oxidant antioxidant balance (PAB) and total antioxidant capacity (TAC) in serum of schizophrenia patients. PAB is an assay to determine the pro-oxidant load and antioxidant capacity in a single measurement. Method: In this cross- sectional study, patients with diagnosis of schizophrenia, who referred to a psychiatry university hospital (Ibn-e-Sina Hospital) affiliated to Mashhad University of Medical Sciences, were enrolled. Patients' demographic characteristics and laboratory data were recorded from patients' files. Serum PAB and TAC were measured using a special PAB assay and commercial kit, respectively. Data were analyzed using SPSS 16. Results: A total of 84 individuals (42 schizophrenia cases and 42 healthy controls) participated in this study. Controls were age and sex-matched with the patients' group. The mean TAC in the patient and control groups was 0.49±0.04 and 0.51±0.04 nmol/L, respectively (p = 0.16). PAB was higher in patients' group than in controls (127.36±36.44 vs. 118.93±52.34 HK), however, this difference was not statistically significant (p = 0.09). The change was correlated with the chronicity of the disease. Conclusion: Pro-oxidant antioxidant balance was elevated in serum of patients with schizophrenia. These data suggested the occurrence of oxidative stress during the progression of the disease. Lower antioxidant capacity might suggest that patients with schizophrenia could be more susceptible to oxidative stress damage. [ABSTRACT FROM AUTHOR]

Background: Determining severity of mitral stenosis (MS) by planimetry of mitral valve orifice area (MVA) has been a challenging issue in clinical practice, especially for less experienced cardiologists. Mitral leaflet separation (MLS) has shown a good correlation with MVA measurements. However, it has never been validated against multiplane 3DTEE planimetry (MVA3D). We aimed to evaluate the accuracy of MLS index (MLSI2D) in predicting MS severity. Methods: We prospectively enrolled 144 patients with MS who underwent clinically indicated 2DTTE and 3DTEE. MLSI2D was yield by averaging the maximal leaflet tip distance in diastole, in parasternal long‐axis and apical four‐chamber views. MVA3D was used as the reference method. Results: MLSI2D showed an excellent discriminatory ability between different grades of MS (P < .001). There was a significant positive correlation between MLSI2D and MVA3D (r = .93, P < .001) irrespective of concurrent mitral regurgitation (r = .94, P < .001) and/or atrial fibrillation (r = .92, P < .001). By receiver operating characteristic (ROC) curves, MLSI2D ≤ 8.6 mm showed 100% sensitivity and 76% specificity for very severe MS. MLSI2D ≥ 11.2 mm determined progressive MS with 100% sensitivity and 82% specificity. The study population was then divided into a derivation group and a validation group. A regression equation for MVA by MLSI2D was derived in first group. Then, the MVA was calculated by this equation in validation group and was not significantly different from MVA3D. Conclusion: MLSI2D showed an excellent ability to assess MS severity and correlates well with planimetered MVA measured by 3DTEE. [ABSTRACT FROM AUTHOR]

Background: In women's health, literacy determines their participation in self and family health promotion. Low health literacy is as barrier for understanding medical recommendations, disease prevention and health care. Aim: To assess women's health literacy and relative factors in Mashhad (Iran). Methods: Women referring to healthcare centers in Mashhad in 2012 and 2013, participated in this crosssectional study by stratified sampling method. The validated Persian version of Rapid Estimate of Adult Literacy in Medicine-revised questionnaire was used. Vocabulary comprehension and reading scores of health literacy was assessed. Comparisons were done in demographic subgroups by ANOVA, Mann-Whitney U, Kruskal-Wallis, Pearson correlation coefficient, and Chi-Square tests. Results: In total, 250 women with a mean age of 32.1±10.23 years and the mean education level of 10.58±3.67 years were studied. The mean reading score was 11.58±2.51 and the mean vocabulary comprehension score was 17.24±4.73. Participants' health literacy score had positive correlation with age and education, and significant difference in health literacy scores between occupational groups was seen. Housewives' health literacy scores were lower than others (p<0.05). Conclusion: Low health literacy was a common problem amongst younger women, especially among women who had less education. These women are at risk of early marriage and child bearing and require more health care. Health care professionals should use effective methods for easier transfer recommendation, also, producing medical information booklets, texts, and videos for different community subgroups through public media or even in cyberspace with clear and common words consisting of essential information. [ABSTRACT FROM AUTHOR]

Background: Unhealthy days are defined as the number of days during the past 30 days that a woman has not had a feeling of wellbeing. Wellbeing includes the woman's judgments about the level of satisfaction and quality in her life. Assessment of a woman's perception of unhealthy days can be used to help her determine the extent of the burdens associated with mental and physical feelings that things are not going well in her life, job and relationship. This study was conducted to measure unhealthy days and the general health status in Iranian women of reproductive age based on their own perceptions. Methods: The participants of this study were women of reproductive age who were referred to health centers in Mashhad, Iran, in 2012. With the stratified random sampling method, 220 women were included in the study. The health-related quality of life-4 (HRQOL-4) questionnaire was used to assess the women's self-perceived unhealthy days. The data that were collected were analyzed by Kruskal-Wallis, chi-squared, Pearson correlation, and logistic linear regression tests with SPSS 11.5. Results: The mean age of the participants was 32.6 years, and the median number of the self-perceived unhealthy days was 7.1 days (per month). In the domains of physical, mental, and disability unhealthy days, the data indicated 2 days, 2.1 days, and 0.1 day in a month, respectively. Also, nearly half of the participants reported that their general health status was poor to fair. The Kruskal-Wallis test showed that there was a significant difference between unhealthy days in the different age groups (p=0.01) as well as for the physical (p=0.02) and mental domains (p=0.4). The results of the regression analysis showed that the number of physical unhealthy days increased with age, number of children, and education. The number of mental unhealthy days increased with age, and the number of disability days increased as the age at which they were married decreased (p<0.05). A significant inverse relationship was observed between physical unhealthy days and education, with the number of physical unhealthy days decreasing as the years of education increased (r=-0.19, p=0.005). Conclusion: Women with less education who were older than 40, who married at an early age, and had more children reported more unhealthy days. These results emphasize the importance of preventive and educational health interventions in these vulnerable groups based on their physical and mental needs. [ABSTRACT FROM AUTHOR]

Background: Pain relief during labour is one of the major concerns in obstetrics; severe labor pain causes fear of the next pregnancy, and interferes with the mother's family relationship. Objective: The aim of this study was to evaluate the analgesic effects of Entonox during labor on reducing the need for pethidine (Meperidine) and fetal-maternal complications. Methods: This double-blind randomized clinical trial was conducted on pregnant women who were candidates for vaginal delivery in Educational Hospitals of Mashhad University of Medical Sciences, Iran between January 2014 and November 2015. After entering into the inactive phase of labor, participants were randomly allocated to receive inhaled Entonox gas (n=200) or inhale Oxygen (n=200) as a control group. Mothers inhaled the gas at commencement of pain, and ceased as soon as the pain diminished, up to the end of the second stage of labor which was the neonate's birth. Main outcomes were pain score based on NRS (numerical rating scale), duration of delivery, required pethidine, maternal complications and satisfaction during labour. Chi-square and Independent T-test were used via SPSS for data analysis and P-value less than 0.05 was considered statistically significant. Results: Four-hundred pregnant women with a mean age of 26.4±5.9 years were studied. Complications such as nausea, vomiting, dizziness, and drowsiness were reported in 25% of the Entonox group and 23% in the control group (p=0.640). Mean of pain severity score during labor in the Entonox and control groups was 4.5±1.2 and 5.2±1.4, respectively (p<0.001). Pethidine requirement, significantly was lower in the Entonox group (31.6±11.8 versus 35.7±12.4; p<0.001). Conclusion: In our study, Entonox significantly reduced pain during delivery without significant increase in maternal and neonatal complications. Trial registration: The trial is registered at the Iranian Clinical Trial Registry (IRCT.ir) with the IRCT identification number IRCT2015102713159N6. Funding: This research has been financially supported by Research Council of Mashhad University of Medical Sciences. [ABSTRACT FROM AUTHOR]

Anogenital warts (AGW) are one of the most common venereal diseases. Psychosocial complications and quality of life (QoL) of AGW patients have been considered only in recent years. Herein, the QoL and psychopathology in patients with AGW are evaluated. In total, 37 AGW patients and 37 healthy controls were recruited in the present cross-sectional study. All participants were provided with the symptom checklist 90-R (SCL-90-R) and short-form (SF-36) questionnaires. All analyses were performed using the SPSS software, version 16.0.1 for Windows. QoL was not significantly different between the study groups (P=0.12). The data showed that mental health, general health, and social functioning were significantly decreased in AGW patients (P<0.05). In addition, AGW patients were significantly more depressed and anxious than the control group (P=0.01 and P=0.04, respectively). AGW has adverse effects on psychological and QoL elements of the infected individuals. Psychological factors should be carefully considered when treating a patient with the HPV virus; hence, referral to a psychiatrist seems mandatory in these cases. [ABSTRACT FROM AUTHOR]

Background and Aim: Gentle music has relaxing and pain reducing effects. In this study, the effect of music on patients' vital signs and pain was investigated before and after endoscopy. Methods: This clinical trial study was conducted on 100 children from seven to fourteen years of age in Gha'em Hospital, Mashhad in 2015. Children were divided into two equal groups (case group=50 and control group=50). The control group received endoscopy according to the standards, without any other procedure. For the case group, a classic musical piece by Clayderman was played during endoscopy (from the time of entering the endoscopy room to the end of the process). After conducting endoscopy, FALCC scale and Baker-Wong pain scale were filled for both groups. In addition, children's vital signs including: heart rate (pulse), diastolic and systolic blood pressure were measured before and after endoscopy for both groups. Data analysis was conducted using SPSS16 with the help of Mann-Whitney and Chi-square tests. Results: No significant difference was found in age, gender distribution of case or control groups (p>0.05). Heart rate and diastolic blood pressure was significantly lower in the music (case) group compared to the control group before endoscopy (p=0.012). In addition, pain score in patients of the music group was lower than the control group (p<0.05). Conclusion: Playing music for children during endoscopy can reduce pain and anxiety in patients before and after endoscopy. [ABSTRACT FROM AUTHOR]

Background: The FAS and FAS-Ligand (FASL) system is an important apoptosis pathway in the liver. The FAS-mediated pathway functions by binding the FASL on the activated cytotoxic T lymphocytes and Natural Killer (NK) cells to the FAS receptor on infected hepatocytes. FAS and FASL polymorphisms, which are related to apoptosis, might influence the outcome of Hepatitis B Virus (HBV) infection. Objectives: Thus, the present study aimed to determine if FAS and FASL promoter polymorphisms are associated with the clinical outcome of HBV infection. Patients and Methods: DNA samples were obtained from the infected individuals including chronic carrier (n = 50), chronic hepatitis (n = 50), cirrhosis (n = 25), naturally recovered (n = 26) and compared with those of their matched healthy controls (n = 100). Genotyping for polymorphisms of FAS-670 A/G and -1377 G/A, and FASL -844 C/T was performed using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) assays. Results: Multiple analyses for genetic association of FAS and FASL polymorphisms were not statistically different between HBV patients (n = 125) and healthy controls (n = 100). However, genotype and allele frequencies of FASL-844 C/T were significantly different between recovered individuals and patients with cirrhosis (P = 0.02 and P=0.01, respectively). Whereas, FAS-670A/G and -1377G/A polymorphisms were similarly distributed in these two groups (P = 0.8 and P = 0.47, respectively). Conclusions: The current study results showed that bearing -844T allele in FASL promoter region has a protective effect on cirrhosis and is involved in recovery from infection. In conclusion, it is proposed that HBV infection outcome might be influenced by FASL-844C/T polymorphism through alteration in apoptosis of hepatocytes. [ABSTRACT FROM AUTHOR]