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Saberzadeh-Ardestani B, Khosravi AA, Mansour-Ghanaei F, Vahedi H, Baniasadi N, Seyyedmajidi M, Parhizkar B, Hormati A, Naghshbandi SJ, Matin S, Hassan Zadeh AA, Taghvaei T, Bahrami M, Rafeey M, Ahadi M, Vossoughinia H, Muosavi H, Gheibi S, Hosseini-Hemmatabadi RS, Yazdanbod A, Matinkhah S, Sheikh Esmaeili F, Fakheri H, Moosavy SH, Maleki I, Nasseri-Moghaddam S, Khosravi B, Farahmand F, Najafi M, Alimadadi H, Malekzadeh M, Anushiravani A, Kasaeian A, Alatab S, Sadeghi A, Radmard AR, Kolahdoozan S, Rajabi Z, Sima AR. Clinical Phenotype and Disease Course of Inflammatory Bowel Disease in Iran: Results of the Iranian Registry of Crohn's and Colitis (IRCC). Arch Iran Med 2024; 27:183-190. [PMID: 38685844 DOI: 10.34172/aim.2024.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/19/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Data on the epidemiology of inflammatory bowel disease (IBD) in the Middle East are scarce. We aimed to describe the clinical phenotype, disease course, and medication usage of IBD cases from Iran in the Middle East. METHODS We conducted a cross-sectional study of registered IBD patients in the Iranian Registry of Crohn's and Colitis (IRCC) from 2017 until 2022. We collected information on demographic characteristics, past medical history, family history, disease extent and location, extra-intestinal manifestations, IBD medications, and activity using the IBD-control-8 questionnaire and the Manitoba IBD index, admissions history, history of colon cancer, and IBD-related surgeries. RESULTS In total, 9746 patients with ulcerative colitis (UC) (n=7793), and Crohn's disease (CD) (n=1953) were reported. The UC to CD ratio was 3.99. The median age at diagnosis was 29.2 (IQR: 22.6,37.6) and 27.6 (IQR: 20.6,37.6) for patients with UC and CD, respectively. The male-to-female ratio was 1.28 in CD patients. A positive family history was observed in 17.9% of UC patients. The majority of UC patients had pancolitis (47%). Ileocolonic involvement was the most common type of involvement in CD patients (43.7%), and the prevalence of stricturing behavior was 4.6%. A prevalence of 0.3% was observed for colorectal cancer among patients with UC. Moreover,15.2% of UC patients and 38.4% of CD patients had been treated with anti-tumor necrosis factor (anti-TNF). CONCLUSION In this national registry-based study, there are significant differences in some clinical phenotypes such as the prevalence of extra-intestinal manifestations and treatment strategies such as biological use in different geographical locations.
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Affiliation(s)
- Bahar Saberzadeh-Ardestani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ali Khosravi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Guilan, Iran
| | - Homayoon Vahedi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nadieh Baniasadi
- Noncommunicable Diseases Research Center, Bam University of Medical Sciences, Bam, Iran
| | | | - Baran Parhizkar
- Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ahmad Hormati
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sayed Jalalledin Naghshbandi
- Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Somaieh Matin
- Department of Internal Medicine, School of Medicine, Lung Diseases Research Center, Ardabil, Iran
- Digestive Diseases Research Center, Imam Khomeini Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
| | | | - Tarang Taghvaei
- Gut and Liver Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohsen Bahrami
- Sasan Alborz Biomedical Research Center, Masoud Gastroenterology and Hepatology Center, Tehran, Iran
| | - Mandana Rafeey
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mitra Ahadi
- Department of Gastroenterology and Hepatology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hassan Vossoughinia
- Department of Gastroenterology and Hepatology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hashem Muosavi
- Sasan Alborz Biomedical Research Center, Masoud Gastroenterology and Hepatology Center, Tehran, Iran
| | - Shahsanam Gheibi
- Maternal and Childhood Obesity Research center, Urmia University of Medical Sciences, Urmia, Iran
| | | | - Abbas Yazdanbod
- Digestive Disease Research Center, Ardabil University of Medical Science, Ardabil, Iran
| | | | - Farshad Sheikh Esmaeili
- Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Hafez Fakheri
- Gut and Liver Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Hamid Moosavy
- Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Iradj Maleki
- Gut and Liver Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Siavosh Nasseri-Moghaddam
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bardia Khosravi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Farahmand
- Pediatric Gastroenterology and Hepatology in Children Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehri Najafi
- Tehran University of Medical Sciences, Tehran, Iran
| | - Hosein Alimadadi
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Anushiravani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Chronic Inflammatory Diseases, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Clinical Research Development Unit, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sudabeh Alatab
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Kolahdoozan
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeynab Rajabi
- Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Sima
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Sasan Alborz Biomedical Research Center, Masoud Gastroenterology and Hepatology Center, Tehran, Iran
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Makharia GK, Sadeghi A, Leddin D, Costello A. Impact of climate change on vulnerable populations. Gut 2023; 72:2201-2204. [PMID: 37977587 DOI: 10.1136/gutjnl-2023-331195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Govind K Makharia
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Anahita Sadeghi
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Desmond Leddin
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anthony Costello
- Institute for Global Health, University College London Institute of Child Health, London, UK
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McCauley ST, Irwin C, Traube B, Khan MK, Sadeghi A, Stea B, Hamilton RJ, Walker GV. Burnout Rates in Clinical Radiation Oncology and Variations across Professional Subgroups. Int J Radiat Oncol Biol Phys 2023; 117:e533-e534. [PMID: 37785653 DOI: 10.1016/j.ijrobp.2023.06.1818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Physician and medical professional burnout has emerged as an important issue in clinical medicine and has been shown to negatively affect patient outcomes. The aim of this study is to determine how rates of burnout vary between different radiation oncology professional subgroups. MATERIALS/METHODS Participants were selected from those employed in one of the professional subgroups (radiation therapists, nurses, physicists, dosimetrists, and physicians) at two institutions that cover a total of seven sites. 126 individuals were recruited to participate. In addition to demographics, participants were asked to respond to questions regarding professional burnout utilizing the Maslach Burnout Inventory (MBI). Responses were on a seven-point Likert scale with subcategories of Exhaustion, Depersonalization, and Personal Achievement. Each participant's score per subcategory was categorized as either low, moderate, or high. For our primary outcome, frequencies and proportions were reported and Fisher's Exact Test was used to evaluate whether there was a statistically significant difference in proportions in categorized burnout scores across professional subgroups. Secondary analyses were performed comparing burnout across sex, age, and categorized years in position. An alpha level of 0.05 was used for all analyses. RESULTS In total, 55 participants responded to the survey: 12 nurses, 8 dosimetrists, 12 physicians, 5 physicists, and 18 radiation therapists for a response rate of 43.6%. Demographics were consistent across professional subgroups with the exception of participant sex (p = .0397), which had a greater proportion of females (72.22%) in the Radiation Therapist subgroup. Among the three subcategories, only Exhaustion had a significant difference between groups (p = .0494) with Dosimetrists (62.50%) and Physicists (40.00%) experiencing the highest level of burnout. For Depersonalization, at least one individual in each subgroup identified high burnout with higher rates among the Dosimetrists (25.00%) and Physicists (40.00%). Similarly, at least one person in each subgroup reported high burnout in Personal Achievement, but the highest response was among Dosimetrists (37.50%). In total, at least 12.75% of participants reported high burnout in at least one subcategory. No statistically significant differences in burnout were detected in our secondary analyses across sex, age, and years in position. CONCLUSION Our study showed that burnout rates are moderate in members of the radiation oncology team, with dosimetrists and physicists displaying the highest levels of burnout. In order to better estimate professional burnout, larger studies should be conducted to determine causes of burnout. Furthermore, wellness programs should be encouraged and incentivized to help reduce burnout and improve workplace morale, occupational fulfillment, and effective patient care.
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Affiliation(s)
- S T McCauley
- University of Arizona College of Medicine Phoenix, Phoenix, AZ
| | - C Irwin
- University of Arizona College of Medicine Phoenix, Phoenix, AZ
| | - B Traube
- University of Arizona College of Medicine Phoenix, Phoenix, AZ
| | - M K Khan
- BC Cancer Agency, Surrey, BC, Canada
| | - A Sadeghi
- Banner MD Anderson Cancer Center, Gilbert, AZ
| | - B Stea
- University of Arizona, Department of Radiation Oncology, Tucson, AZ
| | - R J Hamilton
- University of Arizona, Department of Radiation Oncology, Tucson, AZ
| | - G V Walker
- Banner MD Anderson Cancer Center, Gilbert, AZ
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Vosoghinia H, Saberzadeh-Ardestani B, Anushiravani A, Mansour-Ghanaei F, Fakheri H, Vahedi H, Sheikhesmaeili F, Yazdanbod A, Moosavy SH, Maleki I, Nasseri-Moghaddam S, Khosravi B, Malekzadeh M, Kasaeian A, Alatab S, Sadeghi A, Kolahdoozan S, Amani M, Saberhosseini SN, Rayatpisheh M, Ahadi M, Colombel JF, Ungaro RC, Sima AR, Malekzadeh R. Comparison of Disease Phenotype and Course among Elderly- and Early-Onset Inflammatory Bowel Diseases in the Middle East. Arch Iran Med 2023; 26:481-488. [PMID: 38310403 PMCID: PMC10862057 DOI: 10.34172/aim.2023.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/03/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND It is unknown if the clinical manifestations and phenotype of disease are comparable between early- and elderly-onset inflammatory bowel disease (IBD). We aimed to seek differences in disease phenotype, course, complications, and treatment between early- and elderly-onset IBD patients. METHODS This retrospective cohort study on registered IBD patients in the Iranian Registry of Crohn's and Colitis (IRCC) compared demographics, disease phenotype, disease activity, IBD-related surgery and medications between early- and elderly-onset IBD. A generalized linear regression model was used to investigate the relative risk of age at diagnosis adjusted for gender and disease duration for the outcomes. RESULTS From 10048 IBD patients, 749 with early-onset (7.5%), and 472 (4.7%) elderly-onset IBD were enrolled: 855 (63.1%) ulcerative colitis (UC) and 366 (26.9%) Crohn's disease (CD). Left-sided colitis was more frequent among elderly-onset UC patients (P<0.001). Ileum and ileocolonic locations were the most common types in elderly-onset and early-onset CD patients, respectively. In comparison with elderly-onset UC, early-onset cases more often used prednisolone (22.1% vs. 11.4%, P=0.001), immunomodulators (44.9% vs 25.2%, P<0.001) and anti-tumor necrosis factors (TNF) (20.1% vs 11.9%, P=0.002). Elderly-onset UC patients had 0.7 times lower risk of aggressive phenotype (95%CI:0.6‒0.9, P=0.005). Early-onset CD was associated with higher use of prednisolone (27.7% vs 8.1%, P<0.001), immunomodulators (58.7% vs 41.8%, P=0.005) and anti-TNF (49.6% vs 35.4%, P=0.006). CONCLUSION Early-onset IBD was associated with a more aggressive phenotype and higher prednisolone, immunomodulators, and anti-TNF use.
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Affiliation(s)
- Hasan Vosoghinia
- Gastroenterology and Hepatology Department, Faculty of Medicine, Ghaem Hospital, Mashhad, Iran
| | - Bahar Saberzadeh-Ardestani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Anushiravani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hafez Fakheri
- Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Homayoon Vahedi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sheikhesmaeili
- Liver and Digestive Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Abbas Yazdanbod
- Gastroenterology and Hepatology Department, Digestive Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Seyed Hamid Moosavy
- Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Iradj Maleki
- Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Siavosh Nasseri-Moghaddam
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bardia Khosravi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sudabeh Alatab
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Kolahdoozan
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Maryam Rayatpisheh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Ahadi
- Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jean-Frederic Colombel
- The Henry D. Janowitz Division of Gastroenterology Icahn School of Medicine at Mount Sinai, New York, USA
| | - Ryan C. Ungaro
- The Henry D. Janowitz Division of Gastroenterology Icahn School of Medicine at Mount Sinai, New York, USA
| | - Ali Reza Sima
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Sasan Alborz Biomedical Research Center, Masoud Gastroenterology and Hepatology Center, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Khoshnam-Rad N, Vahedi H, Sadeghi A, Rastegarpanah M, Namazi S, Anushiravani A, Sima AR, Shahrokh S, Alatab S, Malekzadeh R. Iranian Consensus Guideline for Pharmacotherapy with Biologics and Small Molecules Drugs in Adults with Inflammatory Bowel Diseases. Middle East J Dig Dis 2023; 15:83-106. [PMID: 37546508 PMCID: PMC10404092 DOI: 10.34172/mejdd.2023.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/11/2023] [Indexed: 08/08/2023] Open
Abstract
Background: Pharmacotherapy with biologics and small molecules, as the more effective therapies for moderate to severe ulcerative colitis (UC) and Crohn's disease (CD), is complex. Choosing the best methods for their utilization in order to induce and maintain remission are critical for practicing gastroenterologists. We aimed to develop an Iranian consensus on the management of inflammatory bowel disease (IBD) patients with biologics and small molecules. Methods: A Delphi consensus was undertaken by experts who performed a literature summary and voting process. Quality of evidence was assessed using the Grading and Recommendations Assessment, Development, and Evaluation; and an additional risk of bias-protocol. Results: Following an extensive search of the literature, 219 studies were used to determine the quality of the evidence. After three rounds of voting, consensus (defined as≥80% agreement) was reached for 87 statements. Conclusion: We considered different aspects of pharmacotherapy in this consensus. This guideline, along with clinical judgment, can be used to optimize management of IBD patients.
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Affiliation(s)
- Niloofar Khoshnam-Rad
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoon Vahedi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansoor Rastegarpanah
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Soha Namazi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Anushiravani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Sima
- Sasan Alborz Biomedical Research Center, Masoud Gastroenterology and Hepatology Center, Tehran, Iran
| | - Shabnam Shahrokh
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sudabeh Alatab
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Sadeghi A, Leddin D, Malekzadeh R. Mini Review: The Impact of Climate Change on Gastrointestinal Health. Middle East J Dig Dis 2023; 15:72-75. [PMID: 37546513 PMCID: PMC10404088 DOI: 10.34172/mejdd.2023.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/27/2023] [Indexed: 08/08/2023] Open
Abstract
Global warming and climate change are important worldwide issues which are a major human health threat. Climate change can affect the gastrointestinal (GI) system in many ways. Increased rainfall events and flooding may be associated with increased GI infections and hepatitis. Climate change could cause changes in gut microbiota, which may impact the pattern of GI diseases. The stress of access to essential needs such as clean water and food, the effects of forced migration, and natural disasters could increase brain-gut axis disorders. The association between air pollution and GI disorders is another challenging issue. There is a lot to do personally and professionally as gastroenterologists regarding climate change.
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Affiliation(s)
- Anahita Sadeghi
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Reza Malekzadeh
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Salimzadeh H, Sauvaget C, Delavari A, Sadeghi A, Amani M, Salimzadeh S, Karimi A, Ghanbari Motlagh A, Lucas E, Basu P, Malekzadeh R. Colorectal Cancer Screening Pilot Project in Tehran-Iran, a Feasibility Study. Arch Iran Med 2023; 26:138-146. [PMID: 37543936 PMCID: PMC10685729 DOI: 10.34172/aim.2023.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/23/2022] [Indexed: 08/08/2023]
Abstract
BACKGROUND Colorectal cancer (CRC) is the third most common cancer in Iran, where there is no organised CRC-screening programme. This study aimed to evaluate feasibility of CRC screening using a qualitative fecal immunochemical test (FIT) among Iranian average-risk adults. METHODS In this feasibility study, 7039 individuals aged 50-75 years were invited by community health workers (CHWs) in southern Tehran and its suburban districts between April 2018 and November 2019. The CHWs performed a qualitative FIT with cut-off level 50 ng Hb/mL buffer and referred those with positive-FIT for colonoscopy to the endoscopy center of Shariati hospital in Tehran. Outcomes included acceptance rate, FIT positivity rate, colonoscopy compliance, detection rates and positive predictive values (PPVs) with 95% confidence interval for CRC and advanced adenomas (AAs). RESULTS Acceptance rate at initial invitation was 71.7%. From 4974 average-risk adults (1600 males and 3374 females) who were offered FIT, 96.8% (n=4813) provided valid samples, of whom 471 (9.8%) tested positive. Among FIT-positive participants, 150 (31.8%) underwent colonoscopy; CRC was detected in 2.0% (n=3) and adenomas in 27.3% (n=41). Detection rate of CRC and AAs per 1000-FIT-screened participants was 0.6 (0.1-1.8) [males: 0.7 (0.01-3.6), females: 0.6 (0.07-2.0)] and 4.2 (2.5-6.4) [males: 5.9 (2.6-11.0), females: 3.4 (1.7-6.0)], respectively. PPVs were 2.0% (0.4-5.7) for CRC and 13.3% (8.3-19.8) for AAs. There was no association between gender and the studied outcomes. CONCLUSION Our results partially support the feasibility of scaling up organized CRC-screening through the existing healthcare system in Iran; it remains to be discussed carefully to ensure the capacity of healthcare system for adequate colonoscopy services.
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Affiliation(s)
- Hamideh Salimzadeh
- Digestive Oncology Research Centre, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Östra, 416 85, Gothenburg, Sweden
| | - Catherine Sauvaget
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon CEDEX 08, France
| | - Alireza Delavari
- Digestive Oncology Research Centre, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Oncology Research Centre, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amani
- Digestive Oncology Research Centre, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepideh Salimzadeh
- Digestive Oncology Research Centre, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Azita Karimi
- Deputy of Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Eric Lucas
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon CEDEX 08, France
| | - Partha Basu
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon CEDEX 08, France
| | - Reza Malekzadeh
- Digestive Oncology Research Centre, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Sadeghi A, Akbarpour E, Majidirad F, Bor S, Forootan M, Hadian MR, Adibi P, Adibi P. Dyssynergic Defecation: A Comprehensive Review on Diagnosis and Management. Turk J Gastroenterol 2023; 34:182-195. [PMID: 36919830 PMCID: PMC10152153 DOI: 10.5152/tjg.2023.22148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
About one-third of chronically constipated patients have an evacuation disorder, and dyssynergic defecation is a common cause of the evacuation disorder. In dyssynergic defecation, the coordination between abdominal and pelvic floor muscles during defecation is disrupted and patients cannot produce a normal bowel movement. The etiology of dyssynergic defecation is still unknown. Although a detailed history taking and a careful examination including digital rectal examination could be useful, other modalities such as anorectal manometry and balloon expulsion test are necessary for the diagnosis. Biofeedback therapy is one of the most effective and safe treatments. Here, we provide an overview of dyssynergic defecation as well as how to diagnose and manage this condition.
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Affiliation(s)
- Anahita Sadeghi
- Digestive Disease Research Institute (DDRI), Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Akbarpour
- Digestive Disease Research Institute (DDRI), Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Majidirad
- Physical Therapy Department, Tehran University of Medical Sciences Faculty of Rehabilitation Sciences, Tehran, Iran
| | - Serhat Bor
- Department of Gastroenterology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Mojgan Forootan
- Department of Gastroenterology, Gastrointestinal and Liver Diseases Research Center (RCGLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Hadian
- Department of Physical Therapy, Brain and Spinal Cord Injury Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS) Faculty of Rehabilitation Sciences, Tehran, Iran
| | - Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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9
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Labbani-Motlagh Z, Amini S, Aliannejad R, Sadeghi A, Shafiee G, Heshmat R, Jafary M, Talaschian M, Akhtari M, Jamshidi A, Mahmoudi M, Sadeghi K. High-dose Intravenous Vitamin C in Early Stages of Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Double-blind, Randomized, Controlled Clinical Trial. J Res Pharm Pract 2022; 11:64-72. [PMID: 36798102 PMCID: PMC9926917 DOI: 10.4103/jrpp.jrpp_30_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/01/2022] [Indexed: 12/15/2022] Open
Abstract
Objective Based on previous studies in the sepsis population, Vitamin C could prevent injuries when administered in high doses and before the damage is established. This study aimed to evaluate the protective potentials of high-dose Vitamin C in the progression of coronavirus disease 2019 (COVID-19). Methods A double-blind, placebo-controlled clinical trial was conducted. Patients with moderate-to-severe disease severity based on the World Health Organization definition were enrolled and received 12 g/d Vitamin C (high-dose intravenous Vitamin C [HDIVC]) or placebo for 4 days. Sequential Organ Failure Assessment (SOFA) score as a primary outcome, National Early Warning Score, Ordinal Scale of Clinical Improvement, and cytokine storm biomarkers were recorded on days 0, 3, and 5. Survival was also assessed on day 28 after enrollment. Findings Seventy-four patients (37 patients in each group) were enrolled from April 5, 2020, to November 19, 2020, and all patients completed follow-up. A lower increase in SOFA score during the first 3 days of treatment (+0.026 vs. +0.204) and a higher decrease in this parameter in the last 2 days (-0.462 vs. -0.036) were observed in the treatment group. However, these differences did not reach a significance level (P = 0.57 and 0.12, respectively). Other indices of clinical and biological improvement, length of hospitalization, and intensive care unit admission days were the same between the two groups. Treatment did not affect the 28-day mortality. Conclusion Among patients with moderate-to-severe disease of COVID-19, the use of HDIVC plus standard care resulted in no significant difference in SOFA score or 28-day mortality compared to the standard care alone.
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Affiliation(s)
- Zohre Labbani-Motlagh
- Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahideh Amini
- Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran,Department of Pulmonary and Critical Care, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Rasoul Aliannejad
- Department of Pulmonary and Critical Care, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran,Advanced Thoracic Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Anahita Sadeghi
- Liver and Pancreatobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamadreza Jafary
- Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mona Talaschian
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Akhtari
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran,Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Jamshidi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Mahmoudi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran,Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kourosh Sadeghi
- Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran,Address for correspondence: Dr. Kourosh Sadeghi, E-mail:
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10
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Saberzadeh-Ardestani B, Anushiravani A, Mansour-Ghanaei F, Fakheri H, Vahedi H, Sheikhesmaeili F, Yazdanbod A, Moosavy SH, Vosoghinia H, Maleki I, Nasseri-Moghaddam S, Khosravi B, Malekzadeh M, Kasaeian A, Alatab S, Sadeghi A, Kolahdoozan S, Rayatpisheh M, Sima AR, Malekzadeh R. Clinical Phenotype and Disease Course of Inflammatory Bowel Disease: A Comparison Between Sporadic and Familial Cases. Inflamm Bowel Dis 2022; 28:1004-1011. [PMID: 34417824 DOI: 10.1093/ibd/izab202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND The role of genetic and environmental factors in inflammatory bowel disease's (IBD) clinical course is not fully clear. We aimed to assess the clinical phenotype, disease course, and prognosis of familial IBD in comparison with sporadic cases. METHODS We conducted a prospective national matched case-control study of registered IBD patients in the Iranian Registry of Crohn's and Colitis (IRCC) recruited from 2017 until 2020. Sporadic and familial IBD patients were matched based on age, sex, and disease duration. Data on demographics, past medical disease, family history of IBD, disease type, clinical phenotype, extraintestinal manifestations, IBD medications, IBD activity using the IBD-control-8 questionnaire and the Manitoba IBD index, emergency visits in the past 12 months, admissions in the past 3 months, history of colon cancer, IBD-related surgeries, and aggressive phenotype were gathered. Variable distributions were compared between sporadic and familial cases. RESULTS Overall, 5231 patients with ulcerative colitis (UC, 18.3% familial) and 1438 patients with Crohn's disease (CD, 16.7% familial) were registered in the IRCC. Age at diagnosis was similar between familial and sporadic cases. After matching, 3523 UC patients and 908 CD patients were enrolled in the study. Extraintestinal manifestations, UC extent, CD location and behavior, anti-TNF use, disease activity, colon cancer, IBD-related surgeries and the aggressive phenotype were similar between these sporadic and familial cases. CONCLUSIONS The prevalence of familial UC and CD cases in Iran was more similar to western countries, and family history did not show a predictive value for disease phenotype, course, and outcomes in our study.
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Affiliation(s)
- Bahar Saberzadeh-Ardestani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Anushiravani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hafez Fakheri
- Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Homayoon Vahedi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sheikhesmaeili
- Liver and Digestive Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Abbas Yazdanbod
- Gastroenterology and Hepatology Department, Digestive Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Seyed Hamid Moosavy
- Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hasan Vosoghinia
- Gastroenterology and Hematology Department, Faculty of Medicine, Ghaem Hospital, Mashhad, Iran
| | - Iradj Maleki
- Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Siavosh Nasseri-Moghaddam
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bardia Khosravi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sudabeh Alatab
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Kolahdoozan
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Rayatpisheh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Sima
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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11
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Anushiravani A, Saberzadeh-Ardestani B, Vahedi H, Fakheri H, Mansour-Ghanaei F, Maleki I, Nasseri-Moghaddam S, Vosoghinia H, Ghadir MR, Hormati A, Kasaeian A, Radmard AR, Khosravi B, Malekzadeh M, Alatab S, Sadeghi A, Aminisani N, Poustchi H, Sima AR, Malekzadeh R. Susceptibility of Patients with Inflammatory Bowel Disease to COVID-19 Compared with Their Households. Middle East J Dig Dis 2022; 14:182-191. [PMID: 36619152 PMCID: PMC9489316 DOI: 10.34172/mejdd.2022.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 01/11/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND: Immunosuppressive agents used in the treatment of inflammatory bowel diseases (IBDs) could potentially increase the risk of coronavirus disease 2019 (COVID-19). We aimed to compare COVID-19 frequency in patients with IBD with their households and identify the related risk factors. METHODS: Firstly, a multi-centered, observational study on 2110 patients with IBD and 2110 age-matched household members was conducted to compare COVID-19 frequency. Secondly, the data of patients with IBD and COVID-19 who had called the COVID-19 hotline were added. Multivariable logistic regression was used to evaluate the effect of age, type and severity of IBD, the number of comorbidities, and medications on the frequency of COVID-19 among the patients with IBD. RESULTS: The prevalence of COVID-19 in patients with IBD and household groups was similar (34 [1.61%] versus 35 [1.65%]; P = 0.995). The prevalence of COVID-19 increased from 2.1% to 7.1% in those with three or more comorbidities (P = 0.015) and it was significantly higher in those with severe IBD (P = 0.026). The multivariable analysis only showed a significant association with anti-TNF monotherapy (OR: 2.5, CI: 0.97-6.71, P = 0.05), and other medications were not associated with COVID-19. CONCLUSION: The prevalence of COVID-19 in patients with IBD was similar to the household members. Only patients with IBD receiving anti-TNF monotherapy had a higher risk of COVID-19 susceptibility. This finding could be attributed to the higher exposure to the virus during administration in health care facilities.
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Affiliation(s)
- Amir Anushiravani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahar Saberzadeh-Ardestani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoon Vahedi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hafez Fakheri
- Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Iraj Maleki
- Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Siavosh Nasseri-Moghaddam
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hasan Vosoghinia
- Gastroenterology and Hematology Department, Faculty of Medicine, Ghaem Hospital, Mashhad, Iran
| | - Mohammad Reza Ghadir
- Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Science, Iran
| | - Ahmad Hormati
- Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Science, Iran,Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bardia Khosravi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sudabeh Alatab
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nayyereh Aminisani
- Department of Epidemiology and Statistics, Faculty of Health Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Hossein Poustchi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Sima
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author: Ali Reza Sima, MD Digestive Diseases Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Kargar Shomali Avenue, Tehran, Iran Tel: + 98 21 82415000 Fax: + 98 21 82415400
| | - Reza Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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12
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Darvishian M, Sharafkhah M, Mohammadi Z, Sadeghniiat-haghighi K, Abdollahi A, Jafary M, Talaschian M, Tabarsi P, Baghai P, Mardani M, Shayanrad A, Shafighian F, Markarian M, Roozafzai F, Zamani M, Alvand S, Hariri S, Sadeghi A, Poustchi H, Malekzadeh R. SARS-CoV-2 Seroprevalence Among Health Care Workers in Major Private and Public Hospitals With COVID-19 Patient's Referral in Tehran, Iran. Front Public Health 2022; 10:832003. [PMID: 35400056 PMCID: PMC8987007 DOI: 10.3389/fpubh.2022.832003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/22/2022] [Indexed: 12/24/2022] Open
Abstract
Estimating the prevalence of SARS-CoV-2 antibody seropositivity among health care workers (HCWs) is crucial. In this study, the seroprevalence of anti-SARS-CoV-2 antibodies among HCWs of five hospitals of Tehran, Iran with high COVID-19 patient's referrals from April to June, 2020, was assessed. In this cross-sectional study, HCWs from three public and two private hospitals, selected randomly as a pilot, were included. Participants were asked questions on their demographic characteristics, medical history, hospital role, and usage of personal protective equipment (PPE). Iran FDA-approved SARS-CoV-2 ELISA kits were used to detect IgG and IgM antibodies in blood samples. The seroprevalence was estimated on the basis of ELISA test results and adjusted for test performance. Among the 2,065 participants, 1,825 (88.4%) and 240 (11.6%) HCWs were recruited from public and private hospitals, respectively. A total of 340 HCWs were tested positive for SARS-CoV-2-specific IgG or IgM antibodies, and 17.9% of seropositive individuals were asymptomatic. The overall test performance-adjusted seroprevalence estimate among HCWs was 22.6 (95% CI: 20.2–25.1), and PPE usage was significantly higher among HCWs of public vs. private hospitals (66.5 vs. 20.0%). This study found that seroprevalence of SARS-CoV-2 among HCWs was higher in private hospitals (37.0%; 95% CI: 28.6–46.2) than public hospitals (20.7%; 95% CI: 18.2–23.3), and also highest among assistant nurses and nurses, and lowest among janitor or superintendent categories. The PPE usage was especially suboptimal among HCWs in private hospitals. Continued effort in access to adequate PPE and regular screening of hospital staff for detecting asymptomatic personnel, especially during the upcoming wave of infection, are warranted.
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Affiliation(s)
- Maryam Darvishian
- Cancer Control Research, BC Cancer Research Centre, Vancouver, BC, Canada
| | - Maryam Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Alireza Abdollahi
- Department of Pathology, School of Medicine, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mona Talaschian
- Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Payam Tabarsi
- Clinical Tb and Epidemiology Research Center, NRITLD, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvaneh Baghai
- Clinical Tb and Epidemiology Research Center, NRITLD, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Mardani
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amaneh Shayanrad
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Shafighian
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Melineh Markarian
- Digestive Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzin Roozafzai
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Zamani
- Digestive Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Alvand
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanam Hariri
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Hossein Poustchi
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Reza Malekzadeh
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13
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Delavari A, Asgari S, Alimohamadi Y, Vosoogh-Moghaddam A, Sadeghi A, Shahrousvand S, Zakeri A, Moradzadeh R, Akbarpour S. xsGastrointestinal symptoms are associated with a lower risk of hospitalization and mortality and Outcomes in COVID-19. BMC Gastroenterol 2022; 22:119. [PMID: 35272613 PMCID: PMC8908290 DOI: 10.1186/s12876-022-02190-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/02/2022] [Indexed: 12/19/2022] Open
Abstract
Background We aimed to find the association between gastrointestinal (GI) and respiratory symptoms with mortality and hospitalization among COVID-19 patients. Methods We analyzed the registered data of COVID-19 patients from February 20, 2020, to March 10, 2021. Depending on the patients’ disease symptoms, four categories were defined: patients with only GI symptoms, patients with only respiratory symptoms, patients with both symptoms, and patients with other symptoms. Logistic regression analysis was used to assess the association of groups with outcomes. Results A total of 42,964 patients from 23 hospitals were included, of which 26.5% patients had at least one or more GI symptoms. Of total patients, 51.58% patients were hospitalized among which 22.8% had at least one or more GI symptoms. GI symptoms significantly decreased the odds of mortality (OR 0.72, 95% CI 0.56–0.92), but respiratory symptoms increased the odds for mortality (1.36: 1.24–1.50), compared with patients with other symptoms. Moreover, the odds ratio of patients who had both respiratory and GI symptoms increased (1.52: 1.31–1.78) compared with patients with other symptoms. The same results were observed for hospitalization as the outcome. Conclusions Our study showed that the presence of GI symptoms in COVID-19 at the time of admission was associated with a lower odds of hospitalization and mortality; however, this association had higher odds for respiratory symptoms.
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Affiliation(s)
- Alireza Delavari
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital Tehran University of Medical Sciences, Tehran, Iran
| | - Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yousef Alimohamadi
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abbass Vosoogh-Moghaddam
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Department of Internal Medicine, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shokouh Shahrousvand
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Armin Zakeri
- Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Rahmatollah Moradzadeh
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Samaneh Akbarpour
- Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. .,Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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14
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Zamani M, Poustchi H, Shayanrad A, Pourfarzi F, Farjam M, Noemani K, Ghaderi E, Mohammadkarimi V, Kahnooji M, Mansour-Ghanaei F, Rastegar A, Mousavizadeh A, Rafati S, Johari MG, Moosazadeh M, Salehifardjouneghani A, Ostadrahimi A, Mohebbi I, Khorram A, Ardakani FE, Sharafkhah M, Pasdar Y, Sadeghi A, Malekzadeh R. Prevalence and determinants of anemia among Iranian population aged ≥35 years: A PERSIAN cohort-based cross-sectional study. PLoS One 2022; 17:e0263795. [PMID: 35139138 PMCID: PMC8827433 DOI: 10.1371/journal.pone.0263795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/26/2022] [Indexed: 11/19/2022] Open
Abstract
Background So far, no comprehensive studies have been performed to assess burden and determinants of anemia in Iran. In the present study, we aimed to answer this query using the data obtained from the Prospective Epidemiological Research Studies in IrAN (PERSIAN). Methods In this cross-sectional study, we included 161,686 adult participants (aged 35 years and older) from 16 provinces of Iran. Anemia was defined as a hemoglobin concentration of <13 g/dL in males and <12 g/dL in females. To evaluate the association between anemia and different factors, we used the multivariable Poisson regression analysis with robust variance by applying adjusted prevalence ratio (PR) with 95% confidence interval (CI). Results Of the total number of subjects, 72,387 (44.77%) were male and others were female. Mean age was 49.39±9.15 years old. The overall age- and sex-standardized prevalence of anemia was 8.83% (95% CI: 8.70–8.96%) in the included population. The highest and the lowest age- and sex-standardized prevalence of anemia pertained to Hormozgan (37.41%, 95% CI: 35.97–38.85%) and Kurdistan (4.57%, 95% CI: 3.87–5.27%) provinces, respectively. Being female (PR = 2.97), rural residence (PR = 1.24), being retired (PR = 1.53) and housewife (PR = 1.11), third and fourth wealth status quartiles (PR = 1.09 and PR = 1.11, respectively), being underweight (PR = 1.49), drug user (PR = 1.35), inadequate sleep (PR = 1.16), poor physical activity (PR = 1.15), diabetes (PR = 1.09), renal failure (PR = 2.24), and cancer (PR = 1.35) were associated with increased risk of anemia. On the other hand, illiteracy (PR = 0.79) and abdominal obesity (PR = 0.77) decreased the risk of anemia. Conclusions According to the results, a variable prevalence of anemia was observed across the included provinces. We tried to provide an informative report on anemia prevalence for health professionals and authorities to take measures for identification and management of the cases of anemia in high-prevalence areas.
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Affiliation(s)
- Mohammad Zamani
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amaneh Shayanrad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Pourfarzi
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mojtaba Farjam
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Kourosh Noemani
- Department of Disease Prevention and Control, Deputy of Health Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ebrahim Ghaderi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Vahid Mohammadkarimi
- Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmood Kahnooji
- Department of Internal Medicine, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ayoob Rastegar
- Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ali Mousavizadeh
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Shideh Rafati
- Social Determinants in Health Promotion Research Center, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | | | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alizamen Salehifardjouneghani
- Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Department of Pediatrics, College of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Iraj Mohebbi
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Alireza Khorram
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Fatemeh Ezzodini Ardakani
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Anahita Sadeghi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail:
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15
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Sima AR, Saberzadeh-Ardestani B, Vahedi H, Fakheri H, Mansour-Ghanaei F, Maleki I, Nasseri-Moghaddam S, Vosoghinia H, Ghadir MR, Hormati A, Kasaeian A, Radmard AR, Khosravi B, Malekzadeh M, Alatab S, Sadeghi A, Aminisani N, Poustchi H, Gonoudi E, Anushiravani A, Rayatpisheh M, Colombel JF, Ungaro RC, Malekzadeh R. Outcomes of COVID-19 in Patients with Inflammatory Bowel Disease: Comparison with Household Members and the Role of IBD Medications. Arch Iran Med 2022; 25:17-25. [PMID: 35128908 DOI: 10.34172/aim.2022.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/04/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Most data on the effect of inflammatory bowel disease (IBD) and its treatments on coronavirus disease 2019 (COVID-19) outcomes have not had non-IBD comparators. Hence, we aimed to describe COVID-19 outcomes in IBD compared to non-IBD patients. METHODS We conducted a prospective cohort study of registered IBD patients with confirmed COVID-19 from six provinces in Iran from February to April 2020. Proven COVID-19 patients were followed up at four weeks and the frequency of outcomes was assessed. Multivariable logistic regression was used to assess associations between demographics, clinical characteristics and COVID-19 outcomes. RESULTS Overall, 2159 IBD patients and 4721 household members were enrolled, with 84 (3.9%) and 49 (1.1%) participants having confirmed COVID-19, respectively. Household spread of COVID-19 was not common in this cohort (1.2%). While hospitalization was significantly more frequent in IBD patients compared with non-IBD household members (27.1% vs. 6.0%, P=0.002), there was no significant difference in the frequency of severe cases. Age and presence of IBD were positively associated with hospitalization in IBD compared with non-IBD household members (OR: 1.06, 95% CI: 1.03-1.10; OR: 5.7, 95% CI: 2.02- 16.07, respectively). Age, presence of new gastrointestinal symptoms, and 5-aminosalicylic acid (5-ASA) use were associated with higher hospitalization rate in IBD patients (OR: 1.13, 95% CI: 1.05-1.23; OR: 6.49, 95% CI: 1.87-22.54; OR: 6.22, 95% CI: 1.90-20.36, respectively). Anti-tumor necrosis factor (TNF) was not associated with more severe outcomes. CONCLUSION Age, presence of new gastrointestinal symptoms and use of 5-ASA were associated with increased hospitalization rate among IBD patients, while anti-TNF therapy had no statistical association.
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Affiliation(s)
- Ali Reza Sima
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahar Saberzadeh-Ardestani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoon Vahedi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hafez Fakheri
- Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Iradj Maleki
- Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Siavosh Nasseri-Moghaddam
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hasan Vosoghinia
- Gastroenterology and Hematology Department, Faculty of Medicine, Ghaem Hospital, Mashhad, Iran
| | - Mohammad Reza Ghadir
- Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Science, Qom, Iran
| | - Ahmad Hormati
- Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Science, Qom, Iran.,Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bardia Khosravi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sudabeh Alatab
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nayyereh Aminisani
- Department of Epidemiology and Statistics, Faculty of Health Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Hossein Poustchi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elnaz Gonoudi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Anushiravani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Rayatpisheh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Jean-Frederic Colombel
- The Henry D. Janowitz Division of Gastroenterology Icahn School of Medicine at Mount Sinai, New York, USA
| | - Ryan C Ungaro
- The Henry D. Janowitz Division of Gastroenterology Icahn School of Medicine at Mount Sinai, New York, USA
| | - Reza Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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16
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Ali Asgari A, Sazgarnejad S, Haghdoost B, Ghasemi Tirtashi M, Sadeghi A, Malekzadeh R. Colonoscopy Complications in an Iranian Teaching Hospital. Middle East J Dig Dis 2022; 14:51-56. [PMID: 36619721 PMCID: PMC9489328 DOI: 10.34172/mejdd.2022.255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/09/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND: Colonoscopy is generally a safe procedure with a limited number of adverse events. Few studies have addressed the rate of adverse events in teaching hospitals. This study aimed to investigate the rate of complications after colonoscopy performed by gastroenterology fellows in a teaching hospital in Tehran. METHODS: A historical cohort study was carried out to link the colonoscopy reports and the hospital information system to identify serious adverse events leading to unplanned hospitalization, unplanned procedures or interventions (e.g. surgery), prolongation of existing hospitalization, or death within 30 days after colonoscopy. RESULTS: We included 9928 colonoscopies (mean age of the patients 53.0±15.9 years, 52.3% men) in this study. In-hospital patients comprised (34.8%) of the procedures. The indications of colonoscopy included 7137 diagnostic (71.9%), and 2519 screening (25.4%) reasons. Colorectal polyps were found in 2005 (20.2%) patients. Major complications were seen in 17 patients (0.2%), including serious bleeding in seven patients, cardiopulmonary complications in five patients, perforation in four patients, and sepsis in one patient. CONCLUSION: Serious adverse events after colonoscopy are relatively rare. The rate of complications does not appear to be higher in an academic teaching hospital when performed by fellows under supervision.
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Affiliation(s)
- Ali Ali Asgari
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Bahar Haghdoost
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Anahita Sadeghi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author: Anahita Sadeghi, MD Associate Professor of Medicine, Digestive Disease Research Institute (DDRI), Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran, Postal Code: 14117-13135 Telefax:+98 21 8241 5400
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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17
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Forouzesh M, Behnoush B, Sadeghi A, Shahnavaz H, Barzegar A, Bazmi E. Postmortem Liver Pathology Findings in Patients With COVID-19: A Systematic Review. IJMTFM 2021. [DOI: 10.32598/ijmtfm.v11i4.35042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The Coronavirus Disease 2019 (COVID-19) pandemic promptly became a significant public health challenge with extra-pulmonary manifestations, including liver damage. Postmortem examination is crucial for gaining a better understanding of these manifestations and improving patient management. This study summarized the current knowledge of the postmortem liver pathology of patients with COVID-19. Methods: This review was conducted on studies evaluating the postmortem macroscopic and microscopic findings of the liver in patients with COVID-19. Accordingly, we searched 4 electronic databases (PubMed, Scopus, Google Scholar, & Web of Science) until June 2021. From the 317 screened articles, 16 articles examining a total of 332 patients who had died due to COVID-19 were selected. Results: The significant findings of the liver were moderate macro and microvesicular steatosis with mild sinusoidal dilation, active lobular and portal vein thrombosis, mildly-increased lymphocyte filtration in sinusoidal space, and multifocal hepatic necrosis. Additionally, the most common comorbidities were hypertension and other metabolic diseases. In conclusion, liver damage due to COVID-19 infection has various manifestations in patients who have expired due to COVID-19. Conclusion: Therefore, monitoring liver function during the course and treatment of this disease is necessary for better patient management and to decrease the COVID-19-induced mortality rate COVID.
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18
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Ghajari H, Sadeghi A, Khodakarim S, Zali M, Nazari SSH. Designing a Predictive Model for Colorectal Neoplasia Diagnosis Based on Clinical and Laboratory Findings in Colonoscopy Candidate Patients. J Gastrointest Cancer 2021; 53:880-887. [PMID: 34851503 DOI: 10.1007/s12029-021-00737-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Health authorities have expanded two strategies to diminish CRC-related influence: CR screening and improve diagnostic process in symptomatic patients. The aim of the current study is to design a predictive model to identify the most important risk factors that can efficiently predict patients who have high risk of colorectal neoplasia. METHOD A cross-sectional study was constructed to include all patients who had positive test for FIT or had one or more risk factors for colorectal cancer based on the guidelines of detecting high-risk groups for colorectal cancer in Iran. Multivariable binary logistic regression model was constructed for prediction of colorectal neoplasia. We used sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio to check the accuracy. The Hosmer-Lemeshow test, chi-square test, and p value were used to determine the precision of model. RESULT Following an AIC stepwise selection model, only nine potential variables, namely gender, watery diarrhea, IBD, abdominal pain, melena, body mass index, depression drug, anti-inflammatory drug, and age, were found to be a predictor of colorectal neoplasia. The best cut-point probability in the final model was 0.27 and results of sensitivity and specificity, based on maximizing these two criteria, were 66% and 62%, respectively. CONCLUSION Overall, our model prediction was comparable with other risk prediction models for colorectal cancer. It had a modest discriminatory power to distinguish an individual's neoplasia colorectal risk.
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Affiliation(s)
- H Ghajari
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Sadeghi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Khodakarim
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S S Hashemi Nazari
- Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Chamran Highway, Daneshjoo Blvd, 198353-5511, Velenjak Tehran, PC, Iran
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19
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Mobarak S, Salasi M, Hormati A, Khodadadi J, Ziaee M, Abedi F, Ebrahimzadeh A, Azarkar Z, Mansour-Ghanaei F, Joukar F, Yeganeh S, Yaghubi Kalurazi T, Naghipour M, Mehrabi Z, Bahadori AR, Yaghoubi S, Moslemi R, Abbaspour Kasgari H, Fakheri H, Moghimi M, Shabani AM, Nekoukar Z, Babamahmoodi F, Davoudi Badabi AR, Davoodi L, Hassaniazad M, Barahimi E, Tousi A, Sadeghi A, Hosamirudsari H, Ali Asgari A, Abdollahi M, Anushiravani A, Shabani M, Shokouhi S, Khajavirad N, Salehi M, Dehghan Manshadi SA, Mousavi H, Zolfaghari F, Azimi E, Zeinali A, Akbarpour E, Merat D, Eslami G, Mousaviasl S, Sayar S, Radmanesh E, Ebrahimzadeh M, Arizavi Z, Jelvay S, Salmanzadeh S, Esmaeilian H, Mobarak M, Karimi J, Poormontaseri Z, Hasooni Bahrini N, Bonyadi A, Dehghani F, Mirzaei H, Noori Jangi M, Pourmasoomi H, Rezaie Keikhaie L, Afshari M, Nateghi Baygi A, Nateghi Baygi H, Levi J, McCann K, Wentzel H, Simmons B, Hill A, Merat S. Evaluation of the effect of sofosbuvir and daclatasvir in hospitalized COVID-19 patients: a randomized double-blind clinical trial (DISCOVER). J Antimicrob Chemother 2021; 77:758-766. [PMID: 34849957 PMCID: PMC8690191 DOI: 10.1093/jac/dkab433] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/29/2021] [Indexed: 12/15/2022] Open
Abstract
Background The combination of sofosbuvir and daclatasvir has shown preliminary efficacy for hospitalized patients with COVID-19 in four open-label studies with small sample sizes. This larger trial aimed to assess if the addition of sofosbuvir/daclatasvir to standard care improved clinical outcomes in hospitalized patients with COVID-19. Methods This was a placebo-controlled, double-blind, randomized clinical trial in adults hospitalized with COVID-19 at 19 hospitals in Iran. Patients were randomized to oral sofosbuvir/daclatasvir 400/60 mg once-daily or placebo in addition to standard of care. Patients were included if they had positive PCR or diagnostic chest CT, O2 saturation <95% and compatible symptoms. The primary outcome was hospital discharge within 10 days of randomization. Secondary outcomes included mortality and time to clinical events. The trial is registered on the Iran Registry of Clinical Trials under IRCT20200624047908N1. Results Between July and October 2020, 1083 patients were randomized to either the sofosbuvir/daclatasvir arm (n = 541) or the placebo arm (n = 542). No significant difference was observed in the primary outcome of hospital discharge within 10 days, which was achieved by 415/541 (77%) in the sofosbuvir/daclatasvir arm and 411/542 (76%) in the placebo arm [risk ratio (RR) 1.01, 95% CI 0.95–1.08, P = 0.734]. In-hospital mortality was 60/541 (11%) in the sofosbuvir/daclatasvir arm versus 55/542 (10%) in the placebo arm (RR 1.09, 95% CI 0.77–1.54, P = 0.615). No differences were observed in time to hospital discharge or time to in-hospital mortality. Conclusions We observed no significant effect of sofosbuvir/daclatasvir versus placebo on hospital discharge or survival in hospitalized COVID-19 patients.
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Affiliation(s)
- Sara Mobarak
- Abadan University of Medical Sciences, Abadan, Iran
| | - Mehdi Salasi
- Imam Khomeini Hospital of Abadan Petroleum Health Organization, Abadan, Iran
| | - Ahmad Hormati
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran.,Gastroenterology and Hepatology Disease Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Javad Khodadadi
- Infectious Disease Department, Qom University of Medical Sciences, Qom, Iran
| | - Masood Ziaee
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Farshid Abedi
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Azadeh Ebrahimzadeh
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Zohreh Azarkar
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Sara Yeganeh
- Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Tofigh Yaghubi Kalurazi
- Department of Health, Nutrition & Infectious Diseases, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammadreza Naghipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Zeinab Mehrabi
- Department of Infectious Diseases, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Reza Bahadori
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shoeleh Yaghoubi
- Department of Infectious Diseases, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rohollah Moslemi
- Department of Clinical Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hafez Fakheri
- Gut and Liver Research Center, Non-communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Minoo Moghimi
- Department of Clinical Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Mohammad Shabani
- Department of Clinical Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Nekoukar
- Department of Clinical Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farhang Babamahmoodi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Reza Davoudi Badabi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Lotfollah Davoodi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehdi Hassaniazad
- Infectious and Tropical Diseases Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Elham Barahimi
- Infectious and Tropical Diseases Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Abdolali Tousi
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Anahita Sadeghi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ali Ali Asgari
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Anushiravani
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Minoosh Shabani
- Department of Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shervin Shokouhi
- Department of Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasim Khajavirad
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Salehi
- Infectious Diseases Department, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hashem Mousavi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Zolfaghari
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elmira Azimi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Aida Zeinali
- Department of Cardiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Akbarpour
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Dorsa Merat
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Sara Sayar
- Abadan University of Medical Sciences, Abadan, Iran
| | | | | | | | - Saeed Jelvay
- Abadan University of Medical Sciences, Abadan, Iran
| | | | | | | | - Jalal Karimi
- Department of Infectious Disease, Fasa University of Medical Sciences, Fasa, Iran
| | - Zahra Poormontaseri
- Department of Infectious Disease, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Atefeh Bonyadi
- Imam Khomeini Hospital of Abadan Petroleum Health Organization, Abadan, Iran
| | - Fatemeh Dehghani
- Imam Khomeini Hospital of Abadan Petroleum Health Organization, Abadan, Iran
| | - Hadi Mirzaei
- Department of Biotechnology, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Masoome Noori Jangi
- Department of Infectious Diseases, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Hossein Pourmasoomi
- Department of Infectious Diseases, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Lili Rezaie Keikhaie
- Department of Infectious Diseases, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Mahdi Afshari
- Pediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical Sciences, Zabol, Iran
| | - Alireza Nateghi Baygi
- Research and Development Department, Fanavaran Rojan Mohaghegh Darou Co., Tehran, Iran
| | - Helia Nateghi Baygi
- Research and Development Department, Fanavaran Rojan Mohaghegh Darou Co., Tehran, Iran
| | - Jacob Levi
- Department of Intensive Care, University College London Hospital, London, UK
| | - Kaitlyn McCann
- School of Public Health, Imperial College London, London, UK
| | - Hannah Wentzel
- School of Public Health, Imperial College London, London, UK
| | - Bryony Simmons
- Department of Infectious Diseases, Imperial College London, London, UK
| | - Andrew Hill
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - Shahin Merat
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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20
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Sadeghi A, Ali Asgari A, Namazi H, Adibi P. Clinical reasoning during the COVID-19 pandemic. J Res Med Sci 2021; 26:65. [PMID: 34729073 PMCID: PMC8506251 DOI: 10.4103/jrms.jrms_1008_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/30/2020] [Accepted: 01/06/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Anahita Sadeghi
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ali Asgari
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Namazi
- Department of Medical Ethics, Tehran University of Medical Sciences, Tehran, Iran
| | - Peyman Adibi
- Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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21
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Leddin D, Omary MB, Veitch A, Metz G, Amrani N, Aabakken L, Ali RAR, Alvares-da-Silva MR, Armstrong D, Boyacioglu S, Chen Y, Elwakil R, Fock KM, Hamid SS, Makharia G, Macrae F, Malekzadeh R, Mulder CJ, Piscoya A, Perman ML, Sadeghi A, Sáenz R, Saurin JC, Butt AS, Wu K, Lee YY. Uniting the Global Gastroenterology Community to Meet the Challenge of Climate Change and Nonrecyclable Waste. J Clin Gastroenterol 2021; 55:823-829. [PMID: 34617932 DOI: 10.1097/mcg.0000000000001619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Climate change has been described as the greatest public health threat of the 21st century. It has significant implications for digestive health. A multinational team with representation from all continents, excluding Antarctica and covering 18 countries, has formulated a commentary which outlines both the implications for digestive health and ways in which this challenge can be faced.
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Affiliation(s)
| | - M Bishr Omary
- Rutgers University, New Brunswick, NJ, United States
| | | | - Geoffrey Metz
- Monash University and University of Melbourne, Melbourne, Australia
| | | | | | - Raja A R Ali
- National University of Malaysia, Bandar Baru Bangi, Selangor, Malaysia
| | | | | | | | - Ye Chen
- Southern Medical University, Guangzhou, Guangdong Province, China
| | | | - Kwong-Ming Fock
- Duke-NUS Medical School and Changi General Hospital, Singapore, Singapore
| | | | - Govind Makharia
- All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Finlay Macrae
- Royal Melbourne Hospital, Parkville, Vic., Australia
| | | | | | | | | | | | - Roque Sáenz
- Universidad del Desarrollo, Concepción, Chile
| | | | | | - Kaichun Wu
- Xijing Hospital of Digestive Diseases, Xi'an, Shaanxi Province, China
| | - Yeong Yeh Lee
- Universiti Sains Malaysia, Gelugor, Penang, Malaysia
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22
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Leddin D, Omary MB, Veitch A, Metz G, Amrani N, Aabakken L, Raja Ali RA, Alvares-Da-Silva MR, Armstrong D, Boyacioglu S, Chen Y, Elwakil R, Fock KM, Hamid SS, Makharia G, Macrae F, Malekzadeh R, Mulder CJ, Piscoya A, Perman ML, Sadeghi A, Sáenz R, Saurin JC, Butt AS, Wu K, Lee YY. Uniting the Global Gastroenterology Community to Meet the Challenge of Climate Change and Non-Recyclable Waste. Gastroenterology 2021; 161:1354-1360. [PMID: 34629165 DOI: 10.1053/j.gastro.2021.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Desmond Leddin
- Dalhousie University, Canada Chair, WGO Clinical Research Committee
| | - M Bishr Omary
- Rutgers University, United States Past President, American Gastroenterological Association
| | - Andrew Veitch
- Royal Wolverhampton Hospitals, United Kingdom President Elect, British Society of Gastroenterology
| | - Geoffrey Metz
- Monash University and University of Melbourne, Australia Chair, Climate Change Working Group, WGO
| | | | | | | | | | | | | | - Ye Chen
- Southern Medical University, China
| | | | - Kwong-Ming Fock
- Duke-NUS Medical School and Changi General Hospital, Singapore
| | | | | | | | | | | | | | | | | | | | | | | | - Kaichun Wu
- Xijing Hospital of Digestive Diseases, China
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Leddin D, Omary MB, Veitch A, Metz G, Amrani N, Aabakken L, Raja Ali RA, Alvares-Da-Silva MR, Armstrong D, Boyacioglu S, Chen Y, Elwakil R, Fock KM, Hamid SS, Makharia G, Macrae F, Malekzadeh R, Mulder CJ, Piscoya A, Perman ML, Sadeghi A, Saenz R, Saurin JC, Butt AS, Wu K, Yeh Lee Y. Uniting the global gastroenterology community to meet the challenge of climate change and non-recyclable waste. Gut 2021; 70:2025-2029. [PMID: 34620696 DOI: 10.1136/gutjnl-2021-325789] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/03/2021] [Indexed: 01/16/2023]
Affiliation(s)
- Desmond Leddin
- Gastroenterology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - M Bishr Omary
- Department of Medicine, Rutgers Robert Wood Johnson Medical School Camden, Piscataway, New Jersey, USA
| | - Andrew Veitch
- Gastroenterology, New Cross Hospital, Wolverhampton, UK
| | | | | | | | | | | | | | | | - Ye Chen
- Southern Medical University, Guangzhou, China
| | | | - Kwong-Ming Fock
- Duke-NUS Medical School and Changi General Hospital, Singapore
| | | | | | - Finlay Macrae
- University of Melbourne, Melbourne, Victoria, Australia
| | | | - Chris J Mulder
- Amsterdam University Medical Center, Amsterdam, The Netherlands
| | | | | | | | | | | | | | - Kaichun Wu
- Xijing Hospital of Digestive Diseases, Xi'an, China
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Sadeghi A, Alatab S, Alijani N. A case of COVID 19 with concomitant infection with hepatitis A. Rev Esp Enferm Dig 2021; 114:174-175. [PMID: 34663073 DOI: 10.17235/reed.2021.8372/2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Symptoms of COVID-19 range from mild to severe with pulmonary manifestations being predominate, however, liver injury is not rare. There might be a reciprocal influence between COVID-19 and hepatic disease. While high levels of liver enzyme is associated with an increased prevalence of severe complications, search for other etiologies of hepatic disease should be not be ignored. We report a case of COVID-19 presented with acute fulminant hepatitis A (HAV) without previous history.
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Affiliation(s)
- Anahita Sadeghi
- Digestive Disease Research Center, Tehran University of Medical Sciences
| | - Sudabeh Alatab
- Digestive Disease Research Center, Tehran University of Medical Sciences, Iran
| | - Neda Alijani
- Infectious Diseases, Shariati Hospital. Tehran University of Medical Sciences
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25
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Sadeghi A, Amiri R, Akbarpour E, Mirminachi B, Sharifi AH, Merat S. Changes in liver fibrosis in patients with chronic hepatitis C after successful direct-acting antiviral therapy. Int J Clin Pract 2021; 75:e14145. [PMID: 33709413 DOI: 10.1111/ijcp.14145] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 03/09/2021] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES After successful treatment of hepatitis C virus (HCV) infection with direct-acting antivirals (DAAs), the stage of liver fibrosis decreases over time. Here, we aimed to assess the changes in the liver fibrosis stage using transient elastography (TE) after successful DAA therapy in HCV-infected cirrhotic patients who were referred to Shariati hospital from 2016 to 2017. MATERIAL AND METHODS In this observational cohort, all HCV-infected cirrhotic patients who were treated with a combination of sofosbuvir/daclatasvir, had sustained virologic response (SVR), and had undergone pre- and post-treatment TE, were enrolled. The primary outcome was the changes in TE parameters six months after the end of treatment compared with baseline. RESULTS A total of 442 eligible subjects received DAA therapy. Overall, the SVR rate was 96.6%. Of these, 149 patients had completed the protocol and were enrolled. The mean age of patients was 56.1 ± 10.3 years and the predominant sex was male (77.9%). The median (Q1 -Q3 ) liver stiffness (LS) value at baseline was 26.3 kPa (18.1-38 kPa), which significantly decreased to 20.9 kPa (12-29.7 kPa) [z = -8.45, P-value < .001]. Also, the liver steatosis of patients with baseline CAP ≥ 220 dB/m had a significant response to treatment [z = -2.3, P-value = .023]. Based on multivariate analysis, a higher baseline liver fibrosis stage was the only determinant of LS values improvement in our study. CONCLUSION Successful HCV eradication in patients with liver fibrosis results in significant improvement in LS, even in cirrhotic patients.
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Affiliation(s)
- Anahita Sadeghi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Amiri
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Akbarpour
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Mirminachi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir-Houshang Sharifi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Merat
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Jameshorani M, Vahedi H, Sadeghi A, Sima AR, Anushiravani A, Nateghi Beige H, Malekzadeh MM, Naserinejad S, Alatab S. Efficacy and Safety of Tofacitinib for Treatment of Moderate to Severe Active Ulcerative Colitis: First Report from Iran. Arch Iran Med 2021; 24:354-363. [PMID: 34196200 DOI: 10.34172/aim.2021.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 02/27/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Tofacitinib, a selective inhibitor of JAK/STAT pathway, has recently become available in our region. Here, we examined the safety and efficacy of tofacitinib in active ulcerative colitis (UC). METHODS In a prospective, non-randomized, placebo-free, 52-week clinical trial defined in two phases of induction and maintenance, adult patients with active UC and no response or loss of response to previous conventional treatments, or anti-TNF were recruited (IRCT20181217042020N2). Patients received 10 mg/BID of tofacitinib for 8 weeks. Clinically responding patients were entered into the maintenance phase and received tofacitinib 5 mg/BID for 44 weeks. Clinical evaluation, biochemical tests and endoscopy at time points of baseline, 8, 24 and 52 weeks were performed. The primary outcome was clinical remission at 8 and 52 weeks. RESULTS Fifty out of 53 enrolled patients completed the induction phase. Clinical response and clinical remission at 8 weeks occurred in 84% and 9.5%, respectively. Forty-two patients who had clinical response entered the maintenance phase. Clinical remission based on the total Mayo score and the partial Mayo score occurred in 38.9% and 55.3% at 24 weeks and in 61.1% and 72.2% at 52 weeks, respectively. There was significant correlation between the total and partial Mayo score with regard to clinical remission in both 24 and 52 weeks. No serious adverse events, no case of herpes zoster, but two cases of deep vein thrombosis were seen. CONCLUSIONS Our study showed acceptable efficacy and safety for tofacitinib and suggested a correlation between the total Mayo score with partial Mayo score with regard to clinical remission.
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Affiliation(s)
- Maryam Jameshorani
- Department of Internal Medicine, School of Medicine, Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Homayoon Vahedi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Sima
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Anushiravani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Helia Nateghi Beige
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud M Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shokoofeh Naserinejad
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sudabeh Alatab
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Simmons B, Wentzel H, Mobarak S, Eslami G, Sadeghi A, Ali Asgari A, Abbaspour Kasgari H, Tirgar Fakheri H, Merat S, Hill A. Erratum Erratum to: Sofosbuvir/daclatasvir regimens for the treatment of COVID-19: an individual patient data meta-analysis. J Antimicrob Chemother 2021; 76:1653. [PMID: 33704468 PMCID: PMC7989349 DOI: 10.1093/jac/dkab030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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28
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Mansouri Daneshvar MR, Ebrahimi M, Sadeghi A, Mahmoudzadeh A. Climate effects on the COVID-19 outbreak: a comparative analysis between the UAE and Switzerland. ACTA ACUST UNITED AC 2021; 8:469-482. [PMID: 33521243 PMCID: PMC7822754 DOI: 10.1007/s40808-021-01110-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/05/2021] [Indexed: 02/06/2023]
Abstract
The main aim of the present study is to disclose the similarities or differences of the climate effects on the COVID-19 outbreak in two countries, which have different climatic conditions. Using the correlation modeling, the results revealed that some climatic factors, such as the ULR, temperature, and CH4 in the UAE and aerosol index and NO2 in Switzerland have positive lagged correlations with the outburst of COVID-19 by intensifying role within − 9, − 7, and − 2 days. The mitigating role was also observed for ozone/solar radiation and temperature/long-wave radiation in the UAE and Switzerland, respectively. The initial hypotheses of the research have confirmed the correlations between new cases of COVID-19 and ULR and aerosol indices in the UAE and Switzerland. However, the main finding revealed that the climate effects on the COVID-19 outbreak show different roles in the different countries, locating in dissimilar climatic zones. Accordingly, the COVID-19 can be intensified by increases of the ULR and temperature in an arid region, while it can be exactly mitigated by increases of these factors in a temperate area. This finding may be useful for future researches for identifying the essential influencing factors for the mitigating COVID-19 outbreak.
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Affiliation(s)
- M R Mansouri Daneshvar
- Department of Geography and Natural Hazards, Research Institute of Shakhes Pajouh, Isfahan, Iran
| | - M Ebrahimi
- Department of Physical Geography, Hakim Sabzevari University, Sabzevar, Iran
| | - A Sadeghi
- Department of Humanities and Social Science, Farhangian University, Tehran, Iran
| | - A Mahmoudzadeh
- Head of Departments and Chancellor, Research Institute of Shakhes Pajouh, Isfahan, Iran
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Simmons B, Wentzel H, Mobarak S, Eslami G, Sadeghi A, Ali Asgari A, Abbaspour Kasgari H, Tirgar Fakheri H, Merat S, Hill A. Sofosbuvir/daclatasvir regimens for the treatment of COVID-19: an individual patient data meta-analysis. J Antimicrob Chemother 2021; 76:286-291. [PMID: 33063117 PMCID: PMC7665526 DOI: 10.1093/jac/dkaa418] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/13/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The combination of sofosbuvir and daclatasvir has a well-established safety profile and improves clinical outcomes in HCV patients. In silico and in vitro studies suggest that sofosbuvir/daclatasvir may show antiviral activity against SARS-CoV-2. METHODS Three clinical trials comparing sofosbuvir/daclatasvir-based regimens with a comparator in hospitalized COVID-19 patients were combined in a meta-analysis. The primary outcomes measured were clinical recovery within 14 days of randomization, time to clinical recovery and all-cause mortality. A two-step approach was used to analyse individual-level patient data. The individual trial statistics were pooled using the random-effects inverse-variance model. RESULTS Our search identified eight studies of which three met the inclusion criteria (n = 176 patients); two studies were randomized and one was non-randomized. Baseline characteristics were similar across treatment arms. Clinical recovery within 14 days of randomization was higher in the sofosbuvir/daclatasvir arms compared with control arms [risk ratio = 1.34 (95% CI = 1.05-1.71), P = 0.020]. Sofosbuvir/daclatasvir improves time to clinical recovery [HR = 2.04 (95% CI = 1.25-3.32), P = 0.004]. The pooled risk of all-cause mortality was significantly lower in the sofosbuvir/daclatasvir arms compared with control arms [risk ratio = 0.31 (95% CI = 0.12-0.78), P = 0.013]. CONCLUSIONS Available evidence suggests that sofosbuvir/daclatasvir improves survival and clinical recovery in patients with moderate to severe COVID-19. However, the sample size for analysis was relatively small, one of the trials was not randomized and the designs were not standardized. These results need to be confirmed in larger randomized controlled trials.
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Affiliation(s)
- Bryony Simmons
- Department of Infectious Diseases, Imperial College London, London, UK
| | - Hannah Wentzel
- School of Public Health, Imperial College London, London, UK
| | - Sara Mobarak
- Abadan Faculty of Medical Sciences, Abadan, Iran
| | | | - Anahita Sadeghi
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ali Asgari
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamideh Abbaspour Kasgari
- Department of Clinical Pharmacy, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hafez Tirgar Fakheri
- Gut and Liver Research Centre, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shahin Merat
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Andrew Hill
- Department of Translational Medicine, University of Liverpool, UK
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30
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Majidirad F, Asl Soleimani H, Sadeghi A, Hadian MR. Giant mass in a 15-year-old girl. Gastroenterol Hepatol Bed Bench 2021; 14:373-376. [PMID: 34659668 PMCID: PMC8514218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/11/2021] [Indexed: 10/28/2022]
Affiliation(s)
- Fatemeh Majidirad
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Asl Soleimani
- Digestive Disease Research Institute (DDRI), Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Disease Research Institute (DDRI), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Hadian
- Department of Physical Therapy, School of Rehabilitation, Brain & Spinal Cord Injury Research Center, Institute of Neuroscience, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Poustchi H, Darvishian M, Mohammadi Z, Shayanrad A, Delavari A, Bahadorimonfared A, Eslami S, Javanmard SH, Shakiba E, Somi MH, Emami A, Saki N, Hormati A, Ansari-Moghaddam A, Saeedi M, Ghasemi-Kebria F, Mohebbi I, Mansour-Ghanaei F, Karami M, Sharifi H, Pourfarzi F, Veisi N, Ghadimi R, Eghtesad S, Niavarani A, Ali Asgari A, Sadeghi A, Sorouri M, Anushiravani A, Amani M, Kaveh S, Feizesani A, Tabarsi P, Keyvani H, Markarian M, Shafighian F, Sima A, Sadjadi A, Radmard AR, Mokdad AH, Sharafkhah M, Malekzadeh R. SARS-CoV-2 antibody seroprevalence in the general population and high-risk occupational groups across 18 cities in Iran: a population-based cross-sectional study. Lancet Infect Dis 2020; 21:473-481. [PMID: 33338441 PMCID: PMC7833828 DOI: 10.1016/s1473-3099(20)30858-6] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/15/2020] [Accepted: 10/26/2020] [Indexed: 02/03/2023]
Abstract
Background Rapid increases in cases of COVID-19 were observed in multiple cities in Iran towards the start of the pandemic. However, the true infection rate remains unknown. We aimed to assess the seroprevalence of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 18 cities of Iran as an indicator of the infection rate. Methods In this population-based cross-sectional study, we randomly selected and invited study participants from the general population (from lists of people registered with the Iranian electronic health record system or health-care centres) and a high-risk population of individuals likely to have close social contact with SARS-CoV-2-infected individuals through their occupation (from employee lists provided by relevant agencies or companies, such as supermarket chains) across 18 cities in 17 Iranian provinces. Participants were asked questions on their demographic characteristics, medical history, recent COVID-19-related symptoms, and COVID-19-related exposures. Iran Food and Drug Administration-approved Pishtaz Teb SARS-CoV-2 ELISA kits were used to detect SARS-CoV-2-specific IgG and IgM antibodies in blood samples from participants. Seroprevalence was estimated on the basis of ELISA test results and adjusted for population weighting (by age, sex, and city population size) and test performance (according to our independent validation of sensitivity and specificity). Findings From 9181 individuals who were initially contacted between April 17 and June 2, 2020, 243 individuals refused to provide blood samples and 36 did not provide demographic information and were excluded from the analysis. Among the 8902 individuals included in the analysis, 5372 had occupations with a high risk of exposure to SARS-CoV-2 and 3530 were recruited from the general population. The overall population weight-adjusted and test performance-adjusted prevalence of antibody seropositivity in the general population was 17·1% (95% CI 14·6–19·5), implying that 4 265 542 (95% CI 3 659 043–4 887 078) individuals from the 18 cities included were infected by the end of April, 2020. The adjusted seroprevalence of SARS-CoV-2-specific antibodies varied greatly by city, with the highest estimates found in Rasht (72·6% [53·9–92·8]) and Qom (58·5% [37·2–83·9]). The overall population weight-adjusted and test performance-adjusted seroprevalence in the high-risk population was 20·0% (18·5–21·7) and showed little variation between the occupations included. Interpretations Seroprevalence is likely to be much higher than the reported prevalence of COVID-19 based on confirmed COVID-19 cases in Iran. Despite high seroprevalence in a few cities, a large proportion of the population is still uninfected. The potential shortcomings of current public health policies should therefore be identified to prevent future epidemic waves in Iran. Funding Iranian Ministry of Health and Medical Education. Translation For the Farsi translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Darvishian
- Cancer Control Research, BC Cancer Research Centre, Vancouver, BC, Canada
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amaneh Shayanrad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Delavari
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ayad Bahadorimonfared
- Department of Health & Community Medicine, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeid Eslami
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shaghayegh Haghjooy Javanmard
- Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ebrahim Shakiba
- Department of Clinical Biochemistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Emami
- Microbiology Department, Burn & Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Saki
- Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Hormati
- Gastroenterology and Hepatology Disease Research Center, Qom University of Medical Science, Qom, Iran
| | | | - Majid Saeedi
- Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Iraj Mohebbi
- Social Determinants of Health Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Fariborz Mansour-Ghanaei
- Division of Gastroenterology & Hepatology, Gastrointestinal & Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Manoochehr Karami
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Farhad Pourfarzi
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | | | - Reza Ghadimi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Sareh Eghtesad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Niavarani
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ali Asgari
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Sorouri
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Anushiravani
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amani
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Soudeh Kaveh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Feizesani
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Payam Tabarsi
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Keyvani
- Department of Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Melineh Markarian
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Shafighian
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Sima
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Sadjadi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Maryam Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Ghanbari R, Teimoori A, Sadeghi A, Mohamadkhani A, Rezasoltani S, Asadi E, Jouyban A, Sumner SCJ. Existing antiviral options against SARS-CoV-2 replication in COVID-19 patients. Future Microbiol 2020; 15:1747-1758. [PMID: 33404263 PMCID: PMC7789744 DOI: 10.2217/fmb-2020-0120] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 11/18/2020] [Indexed: 02/08/2023] Open
Abstract
COVID-19 caused by SARS-CoV-2, is an international concern. This infection requires urgent efforts to develop new antiviral compounds. To date, no specific drug in controlling this disease has been identified. Developing the new treatment is usually time consuming, therefore using the repurposing broad-spectrum antiviral drugs could be an effective strategy to respond immediately. In this review, a number of broad-spectrum antivirals with potential efficacy to inhibit the virus replication via targeting the virus spike protein (S protein), RNA-dependent RNA polymerase (RdRp), 3-chymotrypsin-like protease (3CLpro) and papain-like protease (PLpro) that are critical in the pathogenesis and life cycle of coronavirus, have been evaluated as possible treatment options against SARS-CoV-2 in COVID-19 patients.
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Affiliation(s)
- Reza Ghanbari
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Science, Tehran 1411713135, Iran
| | - Ali Teimoori
- Department of Virology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan 65178-38678, Iran
| | - Anahita Sadeghi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Science, Tehran 1411713135, Iran
| | - Ashraf Mohamadkhani
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Science, Tehran 1411713135, Iran
| | - Sama Rezasoltani
- Foodborne & Waterborne Diseases Research Center, Research Institute for Gastroenterology & Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran 1985717411, Iran
| | - Ebrahim Asadi
- Department of Veterinary Biomedical Sciences, University of Saskatchewan, Saskatoon, SK, S7N 5B4, Canada
| | - Abolghasem Jouyban
- Pharmaceutical Analysis Research Center & Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz 5166/1573, Iran
| | - Susan CJ Sumner
- Department of Nutrition, Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 28081, USA
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Eslami G, Mousaviasl S, Radmanesh E, Jelvay S, Bitaraf S, Simmons B, Wentzel H, Hill A, Sadeghi A, Freeman J, Salmanzadeh S, Esmaeilian H, Mobarak M, Tabibi R, Jafari Kashi AH, Lotfi Z, Talebzadeh SM, Wickramatillake A, Momtazan M, Hajizadeh Farsani M, Marjani S, Mobarak S. The impact of sofosbuvir/daclatasvir or ribavirin in patients with severe COVID-19. J Antimicrob Chemother 2020; 75:3366-3372. [PMID: 32812051 PMCID: PMC7529105 DOI: 10.1093/jac/dkaa331] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/03/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Sofosbuvir and daclatasvir are direct-acting antivirals highly effective against hepatitis C virus. There is some in silico and in vitro evidence that suggests these agents may also be effective against SARS-CoV-2. This trial evaluated the effectiveness of sofosbuvir in combination with daclatasvir in treating patients with COVID-19. METHODS Patients with a positive nasopharyngeal swab for SARS-CoV-2 on RT-PCR or bilateral multi-lobar ground-glass opacity on their chest CT and signs of severe COVID-19 were included. Subjects were divided into two arms with one arm receiving ribavirin and the other receiving sofosbuvir/daclatasvir. All participants also received the recommended national standard treatment which, at that time, was lopinavir/ritonavir and single-dose hydroxychloroquine. The primary endpoint was time from starting the medication until discharge from hospital with secondary endpoints of duration of ICU stay and mortality. RESULTS Sixty-two subjects met the inclusion criteria, with 35 enrolled in the sofosbuvir/daclatasvir arm and 27 in the ribavirin arm. The median duration of stay was 5 days for the sofosbuvir/daclatasvir group and 9 days for the ribavirin group. The mortality in the sofosbuvir/daclatasvir group was 2/35 (6%) and 9/27 (33%) for the ribavirin group. The relative risk of death for patients treated with sofosbuvir/daclatasvir was 0.17 (95% CI 0.04-0.73, P = 0.02) and the number needed to treat for benefit was 3.6 (95% CI 2.1-12.1, P < 0.01). CONCLUSIONS Given these encouraging initial results, and the current lack of treatments proven to decrease mortality in COVID-19, further investigation in larger-scale trials seems warranted.
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Affiliation(s)
| | | | | | - Saeed Jelvay
- Abadan Faculty of Medical Sciences, Abadan, Iran
| | - Saeid Bitaraf
- Department of Epidemiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Bryony Simmons
- Faculty of Medicine, Imperial College London, London, UK
| | - Hannah Wentzel
- Faculty of Medicine, Imperial College London, London, UK
| | - Andrew Hill
- Department of Translational Medicine, University of Liverpool, UK
| | - Anahita Sadeghi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shokrollah Salmanzadeh
- Infectious and Tropical Diseases Research Centre, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran
| | | | | | - Ramin Tabibi
- Abadan Faculty of Medical Sciences, Abadan, Iran
| | | | - Zahra Lotfi
- Abadan Faculty of Medical Sciences, Abadan, Iran
| | | | | | | | | | | | - Sara Mobarak
- Abadan Faculty of Medical Sciences, Abadan, Iran
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Sadeghi A, Ali Asgari A, Norouzi A, Kheiri Z, Anushirvani A, Montazeri M, Hosamirudsai H, Afhami S, Akbarpour E, Aliannejad R, Radmard AR, Davarpanah AH, Levi J, Wentzel H, Qavi A, Garratt A, Simmons B, Hill A, Merat S. Sofosbuvir and daclatasvir compared with standard of care in the treatment of patients admitted to hospital with moderate or severe coronavirus infection (COVID-19): a randomized controlled trial. J Antimicrob Chemother 2020; 75:3379-3385. [PMID: 32812039 PMCID: PMC7454592 DOI: 10.1093/jac/dkaa334] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/03/2020] [Indexed: 02/07/2023] Open
Abstract
Background Currently no effective antiviral therapy has been found to treat COVID-19. The aim of this trial was to assess if the addition of sofosbuvir and daclatasvir improved clinical outcomes in patients with moderate or severe COVID-19. Methods This was an open-label, multicentre, randomized controlled clinical trial in adults with moderate or severe COVID-19 admitted to four university hospitals in Iran. Patients were randomized into a treatment arm receiving sofosbuvir and daclatasvir plus standard care, or a control arm receiving standard care alone. The primary endpoint was clinical recovery within 14 days of treatment. The study is registered with IRCT.ir under registration number IRCT20200128046294N2. Results Between 26 March and 26 April 2020, 66 patients were recruited and allocated to either the treatment arm (n = 33) or the control arm (n = 33). Clinical recovery within 14 days was achieved by 29/33 (88%) in the treatment arm and 22/33 (67%) in the control arm (P = 0.076). The treatment arm had a significantly shorter median duration of hospitalization [6 days (IQR 4–8)] than the control group [8 days (IQR 5–13)]; P = 0.029. Cumulative incidence of hospital discharge was significantly higher in the treatment arm versus the control (Gray’s P = 0.041). Three patients died in the treatment arm and five in the control arm. No serious adverse events were reported. Conclusions The addition of sofosbuvir and daclatasvir to standard care significantly reduced the duration of hospital stay compared with standard care alone. Although fewer deaths were observed in the treatment arm, this was not statistically significant. Conducting larger scale trials seems prudent.
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Affiliation(s)
- Anahita Sadeghi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ali Asgari
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Norouzi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Science, Gorgan, Iran
| | - Zahedin Kheiri
- Department of Internal Medicine, Baharloo hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Anushirvani
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Montazeri
- Department of infectious diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadiseh Hosamirudsai
- Department of Infectious Diseases, Baharloo Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Shirin Afhami
- Department of infectious diseases, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Elham Akbarpour
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rasoul Aliannejad
- Department of Pulmonary and Critical Care, Shariati Hospital, Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir H Davarpanah
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Jacob Levi
- Department of Emergency Medicine, Homerton University Hospital, London, UK
| | - Hannah Wentzel
- School of Public Health, Imperial College London, London, UK
| | - Ambar Qavi
- School of Public Health, Imperial College London, London, UK
| | - Anna Garratt
- Cardiff and Vale University Health Board, Cardiff, UK
| | - Bryony Simmons
- Department of Infectious Disease, Imperial College London, London, UK
| | - Andrew Hill
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - Shahin Merat
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Sadeghi A, Bagheri Lankarani K. Endoscopy during COVID-19 Pandemic. Middle East J Dig Dis 2020; 12:217-219. [PMID: 33062229 PMCID: PMC7548085 DOI: 10.34172/mejdd.2020.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Anahita Sadeghi
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Bonakdar APS, Sadeghi A, Aghaei HR, Beheshtimaal K, Nazifi SMR, Massah AR. Convenient Synthesis of Novel Chalcone and Pyrazoline Sulfonamide Derivatives as Potential Antibacterial Agents. Russ J Bioorg Chem 2020. [DOI: 10.1134/s1068162020030048] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Gholizadeh Pasha AH, Sadeghi A. Experimental and theoretical studies of frequency response function of dagger-shaped atomic force microscope cantilever in different immersion environments. J Microsc 2020; 279:52-68. [PMID: 32282936 DOI: 10.1111/jmi.12897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 02/08/2020] [Accepted: 04/10/2020] [Indexed: 11/28/2022]
Abstract
In this study, the amplitude of frequency response functions of vertical and rotational displacements and resonant frequency of a dagger-shaped atomic force microscope cantilever have been investigated. To increase the accuracy of theoretical model, all necessary details for cantilever and sample surface have been taken into account. In this paper, carbon tetrachloride (CCL4 ), methanol, acetone, water and air have been considered as the environments. In the most cases, presence and absence of tip-sample interaction force have studied. For a sample cantilever immersed in air, both of the Euler-Bernoulli and Timoshenko beam theories have been compared. The results indicate that the tip-sample interaction force raises the resonant frequency. Increasing the liquid viscosity leads to a decrease in the resonant frequency and the amplitude of frequency response functions of vertical and rotational displacements. Increasing the rectangular and tapered parts lengths, decreases the resonant frequency and amplitude of frequency response functions of vertical and rotational displacements. By increasing the cantilever thickness the resonant frequency and amplitude of frequency response functions of vertical and rotational displacements increases. Theoretical model for air and water has been compared with experimental work. Results show good agreement.
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Affiliation(s)
- A H Gholizadeh Pasha
- Renewable Energy Research Center, Damavand Branch, Islamic Azad University, Damavand, Iran
| | - A Sadeghi
- Renewable Energy Research Center, Damavand Branch, Islamic Azad University, Damavand, Iran
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Saffar H, Saatchi M, Sadeghi A, Asadi Amoli F, Tavangar SM, Shirani F, Aliasgari A. Knowledge of Laboratory Medicine in Medical Students: Is It Sufficient? Iran J Pathol 2020; 15:61-65. [PMID: 32215020 PMCID: PMC7081764 DOI: 10.30699/ijp.2020.94221.1916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 02/23/2019] [Indexed: 11/06/2022]
Abstract
Background & Objective Appropriate use of laboratory testing is essential for achieving safe and effective care to patient. Insufficient knowledge could lead to poor case management and increase the health care costs. It is believed that education on laboratory testing for undergraduate medical student is inadequate. This study was designed to evaluate the level of knowledge of 5 and 6 year undergraduate medical students in field of laboratory medicine. Methods Totally, 59 questions including 8 basic questions concerning individual assessment of their knowledge and 51 objective questions focusing on various stages of test ordering and interpretation were asked. Results Thirty seven undergraduate medical students at the level of internship participated. On average, 47.9% of students evaluated themselves as "weak" in 8 self-assessment questions. There was no significant difference between responders assessment on their own knowledge in various aspects of laboratory testing (P=0.184). In the objective questions regarding various stages of test ordering including pre-analytic, analytic and post analytic phases,45.6%,51.9% and 50% correct answers were reported ,respectively. Comparison of the level of the knowledge of the students regarding various stages of pathology testing did not show significant difference (P=0.638). Conclusion Prioritizing an effective teaching method of laboratory medicine to medical students on appropriate time should be considered in medical school curriculum for better clinical decision making and optimal modern medical care.
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Affiliation(s)
- Hiva Saffar
- Department of Pathology and Laboratory Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Saatchi
- Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Asadi Amoli
- Department of Pathology and Laboratory Medicine, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Tavangar
- Department of Pathology and Laboratory Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Shirani
- Department of Emergency Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Aliasgari
- Digestive Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Fallah H, Karimi A, Sadeghi A, Behroozi-Khazaei N. Modelling and optimizing of calcium and non-phytate phosphorus requirements of male broiler chickens from 1 to 21 days of age using response surface methodology. Animal 2020; 14:1598-1609. [PMID: 32216861 DOI: 10.1017/s1751731120000452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The skeleton is the main site of P and Ca deposition; therefore, accurate estimation of Ca and P requirements is necessary to maintaining health and optimum performance of broiler chickens. A response surface methodology (RSM) using a central composite design (CCD) was used for evaluating and optimizing of Ca and non-phytate P (NPP) requirements of broiler chickens for optimal performance, ileal nutrient digestibility and bone mineralization from 1 to 21 days of age. A total of 750 one-day-old male broiler chickens (Ross 308) were randomly distributed into 50 cages including 9 treatments, each replicated 5 times (except central treatment with 10 replicates) and 15 birds in each cage by CCD. The dietary Ca levels of 4.3, 5.6, 8.6, 11.7 and 13.0 g/kg and NPP of 2.5, 2.9, 4.0, 5.0 and 5.4 g/kg were used for nine treatments of CCD. The results indicated that the linear and quadratic effects of NPP, quadratic effects of Ca and Ca × NPP were significant for average weight gain (AWG, P < 0.05), average feed intake (AFI, P < 0.05), feed conversion ratio (FCR, P < 0.05) and Ca and P apparent ileal digestibility (AID, P < 0.05); however, the linear effect of Ca was significant only for FCR (P < 0.05). On the other hand, tibia and toe ash were affected by NPP (linear and quadratic, P < 0.01) and Ca (quadratic, P < 0.01). The second-order polynomial regression model was significant for AWG (R2 = 0.93, P < 0.001), AFI (R2 = 0.88, P < 0.001), FCR (R2 = 0.78, P < 0.001), AID of Ca (R2 = 0.78, P < 0.001) and P (R2 = 0.88, P < 0.001), tibia ash (R2 = 0.86, P < 0.001) and toe ash (R2 = 0.85, P < 0.001). The multi-objective optimization indicated that broiler chickens from 1 to 21 days of age need 7.03 and 4.47 g/kg of Ca and NPP, respectively, to achieve optimal AWG, FCR, tibia and toe ash. However, the dietary Ca and NPP levels can be reduced to 6.57 and 3.95 g/kg with a slight negative impact on performance and bone mineralization, respectively. In conclusion, the findings indicate that using multi-objective optimization model such as RSM provides more information regarding optimum Ca and NPP requirements of broiler chickens, considering the complex interaction between these two minerals. While the NPP levels are in line with current recommended requirements, Ca levels are considerably lower and suggest that current recommended Ca requirements may be in excess of the needs of the broiler.
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Affiliation(s)
- H Fallah
- Department of Animal Science, Faculty of Agriculture, Pasdaran St., University of Kurdistan, Sanandaj66177-15175, Iran
| | - A Karimi
- Department of Animal Science, Faculty of Agriculture, Pasdaran St., University of Kurdistan, Sanandaj66177-15175, Iran
| | - A Sadeghi
- Department of Animal Science, Faculty of Agriculture, Pasdaran St., University of Kurdistan, Sanandaj66177-15175, Iran
| | - N Behroozi-Khazaei
- Department of Biosystems Engineering, Faculty of Agriculture, Pasdaran St., University of Kurdistan, Sanandaj66177-15175, Iran
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Mohagheghi Darehranj S, Alatab S, Vahedi H, Sadeghi A, Sima A, Malekzadeh M, Anoshiravani A, Fakheri H, Ebrahimi Daryani N, Mousavi A, Mansour-Ghanaei F, Zahedi MJ, Malekzadeh R. Efficacy of Anti-TNF Therapy for the Treatment of Patients with Moderate-to-Severe Inflammatory Bowel Disease; a First Iranian Report. Middle East J Dig Dis 2020; 12:12-18. [PMID: 32082516 PMCID: PMC7023648 DOI: 10.15171/mejdd.2020.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The anti-TNF drugs are shown to be highly effective in treatment of patients with moderate-tosevere inflammatory bowel disease (IBD). Here, we aimed to assess the efficacy and safety of antiTNF therapy at the national level. METHODS IBD patients aged 15 > years who received Infliximab and/or CinnoRA® between 2013 to July 2018 were identified. The data extracted from medical dossier and telephonic interview. The efficacy of therapy was defined as time to drug discontinuation or need for IBD-related surgery. The safety was assessed based on patient's reported adverse events. RESULTS We included 315 patients. The mean age of patients was 37.2 years and 62.2% of them developed the disease before age 30 years. Involvement of masculoskeletal system was reported in 7.3% of patients. Partial and complete response to Anti-TNF therapy was seen in 67% of patients. About 16% of patients did not respond to induction therapy and 16.9% of patients lost their response to Anti-TNF during one year. No serious adverse events, serious opportunistic infection, tuberculosis and malignancies reported by patients. Two patients reported pneumonia. CONCLUSION This study for the first time in our country, provides the evidences for efficacy of anti-TNF therapy in moderate to severe IBD patients.
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Affiliation(s)
- Samaneh Mohagheghi Darehranj
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sudabeh Alatab
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoon Vahedi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Sima
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Anoshiravani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hafez Fakheri
- Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nasser Ebrahimi Daryani
- Department of Gastroenterology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolhamid Mousavi
- Gastroenterology Department, Hormozgan Medical School, Hormozgan University of Medical Sciences, Hormozgan, Bandar-Abbas, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences (GUMS), Rasht, Iran
| | | | - Reza Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Besharati S, Sadeghi A, Ahmadi F, Tajeddin E, Mohammad Salehi R, Fani F, Pouladfar G, Nikmanesh B, Majidpour A, Soleymanzadeh Moghadam S, Mirab Samiee S, Rahnamaye Farzami M, Rahbar M, Eslami P, Rakhshani N, Eshrati B, Gouya MM, Fallah F, Karimi A, Owlia P, Alebouyeh M. Serogroups, and drug resistance of nontyphoidal Salmonella in symptomatic patients with community-acquired diarrhea and chicken meat samples in Tehran. Iran J Vet Res 2020; 21:269-278. [PMID: 33584839 PMCID: PMC7871737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 09/26/2020] [Accepted: 10/26/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Salmonella is considered as a main cause of community-acquired diarrhea in humans, however, sources of the multi-drug resistant (MDR) strains and their link with the disease are not well known. AIMS This study aimed to investigate the frequency, serogroup diversity, and antimicrobial susceptibility patterns of Salmonella strains in poultry meat and stool samples of patients with community acquired diarrhea in Tehran. METHODS We compared the frequency of non-typhoidal Salmonella serogroups, the similarities of their resistance patterns to 10 antimicrobial compounds, the prevalence of extended spectrum β-lactamase (ESBL) and ampicillinase C (AmpC) genetic determinants, and class 1 and 2 integrons in 100 chicken meat and 400 stool samples of symptomatic patients in Tehran during June 2018 to March 2019. RESULTS Salmonella was isolated from 75% and 5.5% of the chicken meats and human stool samples, respectively. The chicken meat isolates mainly belonged to serogroup C (88%, 66/75), while the human stool isolates were mainly related to serogroup D (59.1%, 13/22). The MDR phenotype and the most common rates of resistance to antibiotics, including tetracycline, trimethoprim/sulfamethoxazole (TS) and azithromycin, were detected in 4.5% and 45.3%, 59% and 13.6%, 43% and 9.1%, 42% and 9.1% of the human stool and chicken meat samples, respectively. Carriage of bla CTX, bla SHV, and bla PER genes in the meat isolate with ESBL resistance phenotype and bla ACC, bla FOX, and bla CMY-2 among the 7 meat strains with AmpC resistance phenotype was not confirmed using polymerase chain reaction (PCR). High prevalence of class 1 and 2 integrons was characterized and showed a correlation with resistance to TS and chloramphenicol. CONCLUSION These findings showed a lack of association between chicken meats and human isolates due to discrepancy between the characterized serogroups and resistance phenotypes.
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Affiliation(s)
- S. Besharati
- MSc in Microbiology, Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - A. Sadeghi
- MSc in Microbiology, Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - F. Ahmadi
- MSc Student in Microbiology, Department of Microbiology, Faculty of Basic Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - E. Tajeddin
- MSc in Microbiology, Division of Microbiology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - R. Mohammad Salehi
- Molecular Microbiology Research Center, Faculty of Medicine, Shahed University, Tehran, Iran
| | - F. Fani
- Division of Microbiology, Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gh. Pouladfar
- Division of Microbiology, Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - B. Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - A. Majidpour
- Division of Microbiology, Anti-Microbial Resistance Research Center, Institute of Immunology and Infectious Diseases (IIID), Iran University of Medical Sciences, Tehran, Iran
| | - S. Soleymanzadeh Moghadam
- MSc in Microbiology, Division of Microbiology, Anti-Microbial Resistance Research Center, Institute of Immunology and Infectious Diseases (IIID), Iran University of Medical Sciences, Tehran, Iran
| | - S. Mirab Samiee
- Health Reference Laboratory, Health Reference Laboratory Research Center, Ministry of Health and Medical Education, Tehran, Iran
| | - M. Rahnamaye Farzami
- Health Reference Laboratory, Health Reference Laboratory Research Center, Ministry of Health and Medical Education, Tehran, Iran
| | - M. Rahbar
- Health Reference Laboratory, Health Reference Laboratory Research Center, Ministry of Health and Medical Education, Tehran, Iran
| | - P. Eslami
- MSc in Microbiology, Department of Microbiology, Central Laboratory, Milad Hospital, Tehran, Iran
| | - N. Rakhshani
- Pathology Laboratory, Mehr Hospital, Tehran, Iran
| | - B. Eshrati
- Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - M. M. Gouya
- Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - F. Fallah
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A. Karimi
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - P. Owlia
- Molecular Microbiology Research Center, Faculty of Medicine, Shahed University, Tehran, Iran
- These authors contributed equally in this study
| | - M. Alebouyeh
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- These authors contributed equally in this study
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Jameshorani M, Pourshams A, Sadeghi A, Saffar H, Malekzadeh R. Celiac Crisis in a Young Woman: Raising Awareness of a Life-Threatening Condition. Middle East J Dig Dis 2019; 11:230-233. [PMID: 31824627 PMCID: PMC6895852 DOI: 10.15171/mejdd.2019.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 08/26/2019] [Indexed: 11/15/2022] Open
Abstract
Celiac crisis is a rare, acute, and life-threatening presentation of celiac disease. Its clinical presentations consist of severe watery non-bloody diarrhea, electrolyte disturbances (i.e. hypokalemia, hyponatremia, hypomagnesemia, hypocalcemia, and metabolic acidosis), hypoproteinemia, and dehydration. Here we present a 33-year-old woman who referred with profuse diarrhea, weight loss, hemodynamic instability, hypokalemia, hypoproteinemia, ascites, pancytopenia, and iron deficiency anemia. She used herbal medicines for constipation and had severe weakness after her childbirth. The patient was diagnosed as having celiac disease through pathological and serological evaluations 10 months earlier. Diagnosis of celiac crisis after ruling out the other causes of resistant celiac was made and she was treated with steroids.
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Affiliation(s)
| | - Akram Pourshams
- Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | | | - Hiva Saffar
- Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
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Sadeghi A, Navabakhsh B, Saffar H, Mohamadnejad M. Multiple Raised White Plaques in the Right Colon. Middle East J Dig Dis 2019; 11:234-236. [PMID: 31824628 PMCID: PMC6895851 DOI: 10.15171/mejdd.2019.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/20/2019] [Indexed: 11/20/2022] Open
Affiliation(s)
- Anahita Sadeghi
- Digestive Disease Research Institute, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Behrouz Navabakhsh
- Digestive Disease Research Institute, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hiva Saffar
- Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohamadnejad
- Liver and pancreatobilliary Disease Research Center, Digestive Disease Research Institute, Tehran university of Medical sciences, Tehran, Iran
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44
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Sadeghi A, Ali Asgari A, Moulaei N, Mohammadkarimi V, Delavari S, Amini M, Nasiri S, Akbari R, Sanjari M, Sedighi I, Khoshnevisasl P, Khoshbaten M, Safari S, Mohajerzadeh L, Nabeiei P, Charlin B. Combination of different clinical reasoning tests in a national exam. J Adv Med Educ Prof 2019; 7:230-234. [PMID: 31750362 PMCID: PMC6820014 DOI: 10.30476/jamp.2019.83101.1083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 08/23/2019] [Indexed: 05/21/2023]
Abstract
INTRODUCTION Clinical reasoning as a critical and high level of clinical competency should be acquired during medical education, and medical educators should attempt to assess this ability in medical students. Nowadays, there are several ways to evaluate medical students' clinical reasoning ability in different countries worldwide. There are some well-known clinical reasoning tests such as Key Feature (KF), Clinical Reasoning Problem (CRP), Script Concordance Test (SCT), and Comprehensive Integrative Puzzle (CIP). Each of these tests has its advantages and disadvantages. In this study, we evaluated the reliability of combination of clinical reasoning tests SCT, KF, CIP, and CRP in one national exam and the correlation between the subtest scores of these tests together with the total score of the exam. METHODS In this cross sectional study, a total number of 339 high ranked medical students from 60 medical schools in Iran participated in a national exam named "Medical Olympiad". The ninth Medical Olympiad was held in Shahid Beheshti University of Medical Sciences, Tehran, Iran, under the direct supervision of the Ministry of Health and Medical Education in summer 2017. The expert group designed a combination of four types of clinical reasoning tests to assess both analytical and non-analytical clinical reasoning. Mean scores of SCT, CRP, KF, and CIP were measured using descriptive statistics. Reliability was calculated for each test and the combination of tests using Cronbach's alpha. Spearman's correlation coefficient was used to evaluate the correlation between the score of each subtest and the total score. SPSS version 21 was used for data analysis and the level of significance was considered <0.05. RESULTS The reliability of the combination of tests was 0.815. The reliability of KF was 0.81 and 0.76, 0.80, and 0.92 for SCT, CRP, and CIP, respectively. The mean total score was 169.921±41.54 from 240. All correlations between each clinical reasoning test and total score were significant (P<0.001). The highest correlation (0.887) was seen between CIP score and total score. CONCLUSION The study showed that combining different clinical reasoning tests can be a reliable way of measuring this ability.
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Affiliation(s)
- Anahita Sadeghi
- Digestive Disease Research Institute, Tehran University of medical Sciences, Tehran, Iran
| | - Ali Ali Asgari
- Digestive Disease Research Institute, Tehran University of medical Sciences, Tehran, Iran
| | - Nezarali Moulaei
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis, Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Vahid Mohammadkarimi
- Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Somayeh Delavari
- Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Amini
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Setareh Nasiri
- Department of Gynecology Oncology, Iran University of Medical Sciences, Tehran, Iran
| | - Roghayeh Akbari
- Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mojgan Sanjari
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Iraj Sedighi
- Department of Pediatric, School of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Parisa Khoshnevisasl
- Zanjan Social determinants of health research center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Manouchehr Khoshbaten
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Safari
- Department of Surgery, Firoozgar general hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Leily Mohajerzadeh
- Pediatric Surgery Research Center (PSRC), Research Institute for Children Health (RICH), Mofid Children's Hospital (MCH), Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
| | - Parisa Nabeiei
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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45
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Sotoudehmanesh R, Ali-Asgari A, Khatibian M, Mohamadnejad M, Merat S, Sadeghi A, Keshtkar A, Bagheri M, Delavari A, Amani M, Vahedi H, Nasseri-Moghaddam S, Sima A, Eloubeidi MA, Malekzadeh R. Pharmacological prophylaxis versus pancreatic duct stenting plus pharmacological prophylaxis for prevention of post-ERCP pancreatitis in high risk patients: a randomized trial. Endoscopy 2019; 51:915-921. [PMID: 31454851 DOI: 10.1055/a-0977-3119] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Acute pancreatitis is a serious complication of endoscopic retrograde cholangiopancreatography (ERCP). The aim of this noninferiority study was to evaluate the effectiveness of pancreatic duct (PD) stenting plus pharmacological prophylaxis vs. pharmacological prophylaxis alone in the prevention of post-ERCP pancreatitis (PEP) in high risk patients. METHODS In this randomized, controlled, double-blind, noninferiority trial, patients at high risk of developing PEP were randomly allocated to pharmacological prophylaxis (rectal indomethacin, sublingual isosorbide dinitrate, and intravenous hydration with Ringer's lactate) plus PD stenting (group A) or pharmacological prophylaxis alone (group B). The rate and severity of PEP, serum amylase levels, and length of hospital stay after ERCP were assessed. RESULTS During 21 months, a total of 414 patients (mean age 55.5 ± 17.0 years; 60.2 % female) were enrolled (207 in each group). PEP occurred in 59 patients (14.3 %, 95 % confidence interval [CI] 11.1 % - 17.9 %: 26 patients [12.6 %, 95 %CI 8.6 % - 17.6 %] in group A and 33 [15.9 %, 95 %CI 11.4 % - 21.4 %] in group B). There was no significant difference between the two groups in PEP severity (P = 0.59), amylase levels after 2 hours (P = 0.31) or 24 hours (P = 0.08), and length of hospital stay (P = 0.07). CONCLUSIONS The study failed to demonstrate noninferiority or inferiority of pharmacological prophylaxis alone compared with PD stenting plus pharmacological prophylaxis in the prevention of PEP in high risk patients.
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Affiliation(s)
- Rasoul Sotoudehmanesh
- Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ali-Asgari
- Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Khatibian
- Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohamadnejad
- Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Merat
- Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Keshtkar
- Department of Health Science Educational Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Bagheri
- Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Delavari
- Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amani
- Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoon Vahedi
- Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Siavosh Nasseri-Moghaddam
- Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Sima
- Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Reza Malekzadeh
- Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Mirmohamadsadeghi H, Bayatian A, Dashti M, Ardeshirzadeh M, Kazemifard S, Sadeghi A. Comparison of Oral and Maxillofacial Surgeons’ and Orthodontists’ Treatment Plans for Inclined Class III Patients. J Res Dentomaxillofac Sci 2019. [DOI: 10.29252/jrdms.4.4.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Jannesar M, Sadeghi A, Meyer E, Jafari GR. A Langevin equation that governs the irregular stick-slip nano-scale friction. Sci Rep 2019; 9:12505. [PMID: 31467401 PMCID: PMC6715674 DOI: 10.1038/s41598-019-48345-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/30/2019] [Indexed: 11/26/2022] Open
Abstract
Friction force at the nanoscale, as measured from the lateral deflection of the tip of an atomic force microscope, usually shows a regular stick-slip behavior superimposed by a stochastic part (fluctuations). Previous studies showed the overall fluctuations to be correlated and multi-fractal, and thus not describable simply by e.g. a white noise. In the present study, we investigate whether one can extract an equation to describe nano-friction fluctuations directly from experimental data. Analysing the raw data acquired by a silicon tip scanning the NaCl(001) surface (of lattice constant 5.6 Å) at room temperature and in ultra-high vacuum, we found that the fluctuations possess a Markovian behavior for length scales greater than 0.7 Å. Above this characteristic length, the Kramers-Moyal approach applies. However, the fourth-order KM coefficient turns out to be negligible compared to the second order coefficients, such that the KM expansion reduces to the Langevin equation. The drift and diffusion terms of the Langevin equation show linear and quadratic trends with respect to the fluctuations, respectively. The slope 0.61 ± 0.02 of the drift term, being identical to the Hurst exponent, expresses a degree of correlation among the fluctuations. Moreover, the quadratic trend in the diffusion term causes the scaling exponents to become nonlinear, which indicates multifractality in the fluctuations. These findings propose the practical way to correct the prior models that consider the fluctuations as a white noise.
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Affiliation(s)
- M Jannesar
- Department of Physics, Shahid Beheshti University, G.C., Evin, Tehran, 19839-63113, Iran
| | - A Sadeghi
- Department of Physics, Shahid Beheshti University, G.C., Evin, Tehran, 19839-63113, Iran. .,School of Nano Science, Institute for Research in Fundamental Sciences (IPM), 19395-5531, Tehran, Iran.
| | - E Meyer
- Department Physik, University of Basel, Klingelbergstr. 82, 4056, Basel, Switzerland
| | - G R Jafari
- Department of Physics, Shahid Beheshti University, G.C., Evin, Tehran, 19839-63113, Iran.
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48
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Moradi Y, Ahmadi F, Sadeghi A, Oshvandi K. Conceptualizing and determining core clinical competencies in nursing students: a qualitative study. Int Nurs Rev 2019; 66:530-540. [PMID: 31423593 DOI: 10.1111/inr.12548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 07/14/2019] [Accepted: 07/18/2019] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to conceptualize and explain the core clinical competencies of nursing students in Iran. BACKGROUND/INTRODUCTION Despite the national and international efforts to modify nursing curricula such that the students' clinical competencies are improved, there is still a widespread concern about this issue, perhaps due to the impact of factors other than the curriculum itself, such as the lack of a clear definition for the concept of clinical competency and its main components in nursing students. METHODS This qualitative study was conducted using conventional content analysis. The participants were selected through purposive sampling and included 14 senior students of bachelor of nursing, four nurses working in teaching hospitals and six clinical instructors. Individual semi-structured interviews were used for data collection. After recording and transcribing the interviews, content analysis was used to extract the concepts. FINDINGS The main theme of the study was 'multidimensionality of the concept of clinical competency,' which had six main categories, namely 'adoption of and adaptation with the nursing practice,' 'nursing knowledge,' 'self-direction in clinical learning,' 'patient care skills,' 'professional ethics' and 'the development of professional behaviours.' DISCUSSION/CONCLUSION Clinical competency and its dimensions among students comprise a multidimensional concept. Having a clear and comprehensive understanding of this concept and focusing on its core axes may be the most important step in improving students' clinical competency. IMPLICATIONS FOR NURSING, HEALTH AND EDUCATION POLICY Policymakers and nursing education authorities can identify the problems existing in the students' clinical competency and provide them with practical solutions for a standard professional education through a clear understanding of the concept of clinical competency and its dimensions.
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Affiliation(s)
- Y Moradi
- Chronic Disease (Home Care) Center, Nursing and Midwifery School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - F Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - A Sadeghi
- Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - K Oshvandi
- Mother and Child Care Research Center, Nursing and Midwifery School, Hamadan University of Medical Sciences, Hamadan, Iran
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49
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Abstract
Solitary rectal ulcer syndrome is a multifactorial pathology, which entails a variety of clinical, histologic and endoscopic aspects that needs step-wise logical approach for management especially in relapsing refractory cases. Apart from the diagnostic dilemma that may be faced due to similarities of presentation with inflammatory bowel diseases or colorectal neoplastic lesions, the syndrome also overlaps with dyssynergic defecation syndrome, health anxiety disorder, obsessive compulsive disorder, and latent mucosal rectal prolapse, a systematic composite treatment modality including psychological, pharmacological, physiological and possibly surgical interventions are sometimes essential. Selecting appropriate treatment in this condition not only affects clinical outcome but also patients’ experience and further stigma of SRUS life-long. In this review, we will discuss the detailed pathophysiology, diagnostic and therapeutic approaches in dealing with solitary rectal ulcer syndrome.
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Affiliation(s)
- Anahita Sadeghi
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Biglari
- Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojgan Forootan
- Department of Gastroenterology, Gastrointestinal and Liver Diseases Research Center (RCGLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Peyman Adibi
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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50
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Malekzadeh MM, Sima A, Alatab S, Sadeghi A, Daryani NE, Adibi P, Maleki I, Vossoughinia H, Fakheri H, Yazdanbod A, Taghavi SA, Aghazadeh R, Somi MH, Zendedel K, Vahedi H, Malekzadeh R. Iranian Registry of Crohn's and Colitis: study profile of first nation-wide inflammatory bowel disease registry in Middle East. Intest Res 2019; 17:330-339. [PMID: 31006228 PMCID: PMC6667360 DOI: 10.5217/ir.2018.00157] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 02/08/2019] [Indexed: 12/16/2022] Open
Abstract
Background/Aims A recent study revealed increasing incidence and prevalence of inflammatory bowel disease (IBD) in Iran. The Iranian Registry of Crohn’s and Colitis (IRCC) was designed recently to answer the needs. We reported the design, methods of data collection, and aims of IRCC in this paper. Methods IRCC is a multicenter prospective registry, which is established with collaboration of more than 100 gastroenterologists from different provinces of Iran. Minimum data set for IRCC was defined according to an international consensus on standard set of outcomes for IBD. A pilot feasibility study was performed on 553 IBD patients with a web-based questionnaire. The reliability of questionnaire evaluated by Cronbach’s α. Results All sections of questionnaire had Cronbach’s α of more than 0.6. In pilot study, 312 of participants (56.4%) were male and mean age was 38 years (standard deviation=12.8) and 378 patients (68.35%) had ulcerative colitis, 303 subjects (54,7%) had college education and 358 patients (64.74%) were of Fars ethnicity. We found that 68 (12.3%), 44 (7.9%), and 13 (2.3%) of participants were smokers, hookah and opium users, respectively. History of appendectomy was reported in 58 of patients (10.48%). The most common medication was 5-aminosalicylate (94.39%). Conclusions To the best of our knowledge, IRCC is the first national IBD registry in the Middle East and could become a reliable infrastructure for national and international research on IBD. IRCC will improve the quality of care of IBD patients and provide national information for policy makers to better plan for controlling IBD in Iran.
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Affiliation(s)
- Masoud M Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Sima
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sudabeh Alatab
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasser Ebrahimi Daryani
- Department of Gastroenterology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Payman Adibi
- Gastroenterology Section, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Iradj Maleki
- Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hassan Vossoughinia
- Department of Gastroenterology and Hepatology, Ghaem Hospital, Medical Faculty, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hafez Fakheri
- Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Yazdanbod
- Department of Medicine, Ardabil University of Medical Science, Ardabil, Iran
| | - Seyed Alireza Taghavi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rahim Aghazadeh
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kazem Zendedel
- Ministry of Health and Medical Education, Tehran, Iran.,Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoon Vahedi
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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