Predisposing Factors and Clinical-Microbiological Profile of Neonatal Corneal Ulcer: A Systematic Review and Analysis

OBJECTIVE

To provide a comprehensive overview of predisposing factors and clinical-microbiological profile of neonatal corneal ulcer.

METHODS

The literature search was undertaken in PubMed, SCOPUS, Embase, Web of Science, and Google Scholar databases on published papers from inception to May 31, 2023. The included articles were independently assessed for methodological quality using a Joanna Briggs Institute checklist. Weighted analysis was utilized, assigning a weight of one to each case report and a weight equivalent to the sample size for the case series/original studies.

RESULT

We included 34 relevant case reports/series and one original study. Seventy-four neonates were enrolled with a boy-to-girl ratio of 1.3:1 and a median age of 17 days (1-27 days). Prematurity and neonatal intensive care unit (NICU) care (21.6%), congenital horizontal tarsal kink (13.5%), neonatal herpes infection (13.5%), congenital entropion (5.4%), and jaundice (5.4%) were the most common potential risk factors and coexisting conditions. Microbiology evaluation showed positive results in 53.8% (21/39 cases). Viral and bacterial infections were the most common cause, followed by fungal infections. Herpes virus (18.9%), Pseudomonas aeruginosa (18.9%%) and Staphylococcus epidermidis (6.7%) were the most prevalent causative agents. Negative microbiology was significantly more common in neonates with structural abnormalities (14.9%) compared to others (6.8%) (p = 0.01).

CONCLUSION

Based on the findings of reported studies, this systematic review has increased awareness of the risk factors and etiologies that lead to developing corneal ulcers in neonates.

Characteristics of Hospitalized Pediatric Patients Following Traumatic Open Globe Injuries; a Cross-sectional Study

Introduction

One of the main causes of acquired blindness and impairment in children is ocular trauma. This study aimed to evaluate the epidemiological and clinical characteristics of pediatric patients hospitalized with open globe injuries (OGI).

Methods

A retrospective cross-sectional study was conducted on children diagnosed with OGI at a referral Hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran, from 2014 to 2018.

Results

375 OGI medical records were detected during the study period. The common culprits for OGI in boys were knives (21.3%), wood (19.7%), metal bodies (12.2%), and glass (11.8%). In girls, the common causes were knives (28.7%), glass (24.3%), pencils (11.3%), and wood (10.4%). Boys had a greater rate of Intraocular foreign body (IOFB) (p= 0.052) but had lower odds of blindness compared to girls (OR=0.48; 95% CI: (0.24, 0.98); p = 0.04). Patients with corneal lacerations had lower chances of long-term admission than those with corneal and scleral lacerations (OR= 0.35, 95% CI: (0.17, 0.69); p = 0.02).

Conclusion

Most pediatric OGIs occur in boys. knives were the principal culprit for OGI, followed by glass and wood. Boys had a greater IOFB rate but lower blindness odds than girls.

Retinal and choroidal microvasculature in early and three months post COVID-19: A case-control study

To compare the retinal vascular density (VD), choroidal vascularity index (CVI), and choroidal thickness (CHT) between patients infected with COVID-19 and healthy subjects using non-invasive optical coherence tomography angiography (OCTA) and enhanced depth imaging OCT (EDI-OCT) technique. This case-control study was carried out on patients with COVID-19 and healthy controls. Patients' data were acquired immediately after active infection and three months later. The diagnosis was based on clinical symptoms and a positive PCR test. VDs in superficial and deep capillary plexuses (SCP and DCP) and CHT and CVI were measured and compared between groups. A total of 160 eyes from 80 patients (55% female, mean age 51 ± 13 years) and 80 controls (55% female, mean age 49 ± 12 years) were enrolled. In acute phase infection, the mean foveal avascular zone (FAZ) area was 0.28 ± 0.06 mm2 and 0.22 ± 0.05 mm2 in patient and control groups, respectively (P < 0.001). CVI was 61.06 ± 2.59 µm and 72.28 ± 3.84 µm in patients and control groups, respectively (P < 0.001). After three months, the mean FAZ area was 0.28 ± 0.06 mm2 and 0.23 ± 0.05 mm2 in the patient and control groups, respectively (P < 0.001). CVI was 60.93 ± 2.11 µm and 72.46 ± 3.80 µm in patients and control groups, respectively (P < 0.001). Subfoveal CHT was not significantly different between groups (P = 0.69). SCP and DCP VDs were significantly less in the patients' group (P < 0.001). In the patients' group, the VDs in the DCP of the whole images and parafoveal DCP (P < 0.001) were reduced significantly after three months in comparison to the acute phase, while the FAZ area, subfoveal CHT, and CVI were not significantly different. COVID-19 infection may be associated with acute and long-term changes of VDs in the retinal and choroidal vasculature without significant effect on the subfoveal CHT.

Evaluation of the frequency of ABO and Rh-Hr blood-group systems in different acquired cataracts type

OBJECTIVES

This study evaluated the relationship between acquired cataract's different types and the ABO and Rh blood classes.

METHODS

Overall, 520 patients, by randomized sampling method, participated in this retrospective cross-sectional study. After reviewing the patient's medical records and laboratory results, the patient's demographics, ABO group, Rh, and cataract type were documented.

RESULTS

A total of 520 patients were included in the research, with a mean age of 67.57 ± 11.85. Most of them were female (n = 286, 55%). Mix (n = 230, 44%) and nuclear sclerotic (NS) (n = 167, 32%) cataracts were the most common types. The posterior subcapsular cataract (PSC) prevalence in females was significantly higher than in males (16.1% vs.7.3% p = 0.002). Also, men had more NS cataracts than females (89, 38% vs. 78, 27.3%) (p = 0.009). Patients with PSC were significantly younger than others (all p-values < 0.001). Our results showed that cataract types are independent of blood group types and Rh (P > 0.05).

CONCLUSION

Although our findings showed that cataract types are independent of blood group types and Rh, they can be compared with future studies on the association of other Blood-Group Systems in developing acquired cataracts.

Clinical efficacy of Fluorometholone versus Loteprednol eye drops after photorefractive keratectomy: A triple-blinded randomized controlled trial

PURPOSE

This study aimed to compare the anti-inflammatory efficacy and safety of 0.1% Fluorometholone (FML) versus (vs.) 0.5% Loteprednol etabonate (LE) following photorefractive keratectomy (PRK).

METHODS

A triple-blinded randomized controlled trial was conducted on both eyes of 100 patients with stable refraction who were candidates for PRK. Both eyes in each subject were randomly allocated to the FML or LE groups. The product to be tested was 0.1% FML eye drops packaged in droppers vs. the 0.5% LE sterile ophthalmic suspension (Lotemax®) packaged in identical droppers. The main clinical outcomes were changes in best-corrected distance visual acuity (BCDVA) and corneal optical density. The second clinical outcomes were a change in intraocular pressure (IOP) after the intervention.

RESULTS

There was no significant difference regarding mean corneal optical density changes between the two groups, one (P = 0.55) and three months (P = 0.98) after the intervention. The mean ± SD BCDVA after one month of the intervention was 0.79 ± 0.11 and 0.84 ± 0.11 in LE and FML groups, retrospectively (P = 0.02). There was no significant difference regarding mean BCDVA between the two groups three months after intervention (P = 0.21). The IOP showed no significant difference between the two groups after one (P = 0.18) and three months (P = 0.53) of the intervention.

CONCLUSIONS

The results of this clinical trial demonstrate that LE and FML treatment was effective with no clinically meaningful effect on IOP following a short course of treatment.

Paediatric myopia shift during the COVID-19 pandemic home quarantine: a systematic review and meta-analysis

BACKGROUND

Outdoor activities were restricted during the COVID-19 outbreak, although digital learning grew. Concerns have been raised about the impact of these environmental changes on myopia status. This research aimed to examine myopia shift during the COVID-19 pandemic and offer the community evidence-based data.

METHODS

The literature search was undertaken in PubMed, SCOPUS, Science Direct, Web of Science and Google Scholar databases on published papers before 17 May 2022. The main outcome was mean spherical equivalent refraction (SER) before, at the onset and at the end of follow-up during the COVID-19 pandemic.

RESULTS

Among 518 articles, 10 studies were included in the meta-analysis. The mean SER differences during the COVID-19 pandemic follow-up (mean follow-up time was 10 months) compared with before the pandemic was 0.15 dioptre (D) (95% CI -0.39 to 0.69, p=0.58). After age adjustment using meta-regression, the mean SER differences during the COVID-19 follow-up compared with before the pandemic was - 0.46 D (95% CI -0.59 to -0.34, p<0.001). Over the mean follow-up time during the COVID-19 pandemic, the SER mean difference was -0.55 D (95% CI -0.78 to -0.32, p<0.001), showing that the mean SER had decreased significantly during the COVID-19 pandemic. The mean SER differences in myopic patients before COVID-19 compared with during the pandemic follow-up was -0.49 D (95% CI -0.53 to -0.45, p=0.00). So the prior pandemic myopic patients became more myopic during the pandemic follow-up time.

CONCLUSION

During home quarantine, the mean SRE shifting in paediatrics accelerated. This phenomenon should be given more attention by policymakers, eyecare experts, educators and parents.

Atypical intraorbital dermoid and epidermoid cyst: A single institution cross-sectional retrospective study

Purpose

Intraorbital epidermoid and dermoid cyst (DC) has been reported in the literature rarely. The current study evaluates clinicopathologic, radiologic, and management of intraorbital DC cases over ten years.

Methods

In this cross-sectional study, the medical records of patients with intraorbital DC treated at the academic referral center for ocular surgery were retrospectively reviewed. Data reviewed included the patient's demographic characteristics, clinical features, imaging, surgical technique, and pathology report.

Results

Nine patients with a rare presentation of intraorbital DC were reviewed within the study period in five presentations (five intraosseous, one intraconal, one dumbbell-shaped with a large part in anterior orbit, one juxta levator palpebral muscle, and one recurrent case with intracranial extension). They ranged from 8 to 53 years of age, with a median of 29 years, and five (55.6%) were female. Histopathological evaluation revealed two cysts were epidermoid.

Conclusion

The current study provides more clinical and radiologic manifestations of rare presentations of DC that highlight the importance of high clinical suspicion in the approach to atypical DC.

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The mean age of patients with intraorbital dermoid/epidermoid cyst was higher than periocular that usually present in early infancy.

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The most clinical signs of patients with intraorbital dermoid/epidermoid cyst were hypophthalmos, proptosis, lid puffiness, and ptosis.

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In addition to the atypical clinical presentation of intraorbital dermoid/epidermoid cyst, the radiological investigation is doubted potentially and can be caused mixed missed cases. So histopathological evaluation is essential for confirmation of the diagnosis.

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It may be difficult or impossible to excise a complete intraosseous dermoid/epidermoid cyst. In such cases, evacuating cyst contents allowed for easier dissection around the lesion. In addition, burring the bone is necessary in cases where there is an intimate connection of the cyst wall to the bone.

Motivations for alcohol consumption during the COVID-19 pandemic in Islamic Republic of Iran

Background: High alcohol consumption is an important public health problem, and understanding factors associated with such consumption is essential. Aims: This study aimed to assess individual and social factors associated with alcohol consumption during the coronavirus disease 2019 (COVID-19) pandemic in the Islamic Republic of Iran. Methods: In this qualitative study, purposive sampling was used to select study participants by sharing the survey link on the Telegram application channels with an Iranian audience during COVID-19. The study was conducted from March to June 2020 and reached all Iranian provinces. We used qualitative content analysis to investigate specific concepts in the responses. Results: Of the 116 participants who responded to the survey, 34 (29.3%) were females, and 82 (70.7%) were male. The mean age of the participants was 34.8 years (standard deviation 9.9; range 17–71 years). Most of the participants (75.9%) reported having consumed alcohol, and 56.9% reported having self-medicated for an illness without a doctor’s prescription before the COVID-19 pandemic. The most common reason given for alcohol consumption was to relieve stress during home quarantining (32.3%). Based on analysis of the responses, two themes emerged: coping motivations and coping skills, with five subthemes and 14 basic codes. Coping motivations were more powerful than coping skills in relation to high alcohol consumption. Conclusion: Poor coping skills and strong motivations, combined with misinformation on social media and the internet, appear to have led to new or higher alcohol consumption among survey respondents.

The role of NK and NKT cells in the pathogenesis and improvement of multiple sclerosis following disease‐modifying therapies

Background

Multiple sclerosis (MS) is an autoimmune inflammatory disease of the central nervous system (CNS) that T cells become autoreactive by recognizing CNS antigens. Both innate and adaptive immune systems are involved in the pathogenesis of MS. In recent years, the impact of innate immune cells on MS pathogenesis has received more attention. CD56^bright NK cells, as an immunoregulatory subset of NK cells, can increase the production of cytokines that modulate adaptive immune responses, whereas CD56^dim NK cells are more active in cytolysis functions. These two main subsets of NK cells may have different effects on the onset or progression of MS. Invariant NKT (iNKT) cells are other immune cells involved in the control of autoimmune diseases; however, variant NKT (vNKT) cells, despite limited information, could play a role in MS remission via an immunoregulatory pathway.

Aim

We aimed to evaluate the influence of MS therapeutic agents on NK and NKT cells and NK cell subtypes.

Materials and Methods

The possible mechanism of each MS therapeutic agent has been presented here, focusing on the effects of different disease‐modifying therapies on the number of NK and NKT subtypes.

Results

Expansion of CD56^bright NK cells, reduction in the CD56^dim cells, and enhancement in NKT cells are the more important innate immune cells alterations following the disease‐modifying therapies.

Conclusion

Expansion of CD56^bright NK cells or reduction in the CD56^dim cells has been associated with a successful response to different treatments in MS. iNKT and vNKT cells could have beneficial effects on MS improving. It seems that they are enhanced due to some of MS drugs, leading to disease improvement. However, a reduction in the number of NKT cells could be due to the adverse effects of some of MS drugs on the bone marrow.

Orexin neuropeptides modulate the hippocampal-dependent memory through basolateral amygdala interconnections

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Orexin neuropeptides roles in hippocampal-dependent memory formation.

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Orexin neuropeptides activate the neural circuits of the basolateral amygdala.

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The power of memorization is modulated by the level of orexin neuropeptides.

Orexin neuropeptides have functional roles in hippocampal-dependent memory formation via the consolidation and retrieval of passive avoidance and spatial memories. The effects of these neuropeptides have been confirmed on the induction of long-term potentiation (LTP). The orexinergic system seems to have modulatory effects by sending projection fibers to several brain parts, such as the hippocampus and amygdala. Orexin neuropeptides activate the neural circuits of the basolateral amygdala during different arousal events with various emotional loads. Therefore, this system plays a vital role in creating appropriate behavioral reactions and responses particular to the situation. This review aimed to report new progression and advances in the hippocampus function in memory by focusing on its relationship with the amygdala through the orexinergic system.

Transient osteoporosis of the hip: Physicians the occupation of at risk

Physicians are the occupation at risk for Transient Osteoporosis of the Hip. Therefore, sudden hip pain in them should be further evaluated with magnetic resonance imaging. Conservative treatment may help avoid further injury and speed up healing.

Psychometric Evaluation of Persian Version of Hope Scale in Iranian Patients With Cancer

BACKGROUND AND PURPOSE

Adult Hope Scale is one of the most popular tools for hope measuring. The study aimed to evaluate the psychometric properties of the Persian Version of Hope Scale among Iranian patients with cancer.

METHODS

In this methodological study, patients with cancer (n = 400) were recruited by convenience sampling from June to December 2019. The construct and content validity and reliability of the scale were evaluated.

RESULTS

A two-factor structure for the scale was indicated with the factors being optimism life, and despair that explained 60.483% of the total variance of the scale. The model has the goodness of fit and acceptable internal consistency (Cronbach's alpha: .701-.897).

CONCLUSIONS

The Persian Version of Hope Scale demonstrated acceptable validity and reliability among patients with cancer.

The association between sleep quality, health status and disability due to breathlessness in chronic obstructive pulmonary disease patients

BACKGROUND

Chronic obstructive pulmonary disease (COPD) increases susceptibility to sleep disturbances. This study aimed to evaluate the association between COPD severity criteria with sleep quality.

METHODS

One hundred fifty-eight patients in Rasul Akram Hospital of Iran University of Medical Sciences, Tehran, Iran, from April 2019 to March 2021 diagnosed with COPD were examined using the Pittsburgh Sleep Quality Index (PSQI), COPD Assessment Test (CAT), modified Medical Research Council (mMRC) dyspnoea scale, spirometry and pulse oximetry.

RESULTS

Of 158 subjects, 125 patients were male (79%), and 33 were female (21%). The mean subject's age and FEV1/FVC ratio were 62.6 ± 11.5 and 65.6 ± 14.9%, respectively. The mean CAT scoring and Spo2 saturation reported 16.2 ± 7 and 91.5 ± 10.8%, respectively. The mean PSQI score was 8.2 ± 3.8. The association between PSQI score with FEV1 and FEV1/FVC ratio was not statistically significant (p = 0.64 and 0.58, respectively), whereas the association between PSQI scores with CAT score (p ˂ 0.0001, r²  = 0.51) and dyspnoea severity (p ˂ 0.0001, r²  = 0.29) were statistically significant. The patients with higher CAT score demonstrated poor sleep quality, particularly in longer sleep latency (p = 0.001, r²  = 0.056), bad subjective sleep quality (p ˂ 0.0001, r²  = 0.286), lower sleep efficiency (p = 0.002, r²  = 0.077), higher sleep disturbance (p ˂ 0.0001, r²  = 0.225), daytime dysfunction (p ˂ 0.0001, r²  = 0.259) and sleep medication intake times a week (p = 0.01, r²  = 0.069). Dyspnoea severity was attributed to bad subjective sleep quality (p ˂ 0.0001, r²  = 0.069), higher sleep disturbances (p = 0.005, r²  = 0.08), and daytime dysfunction (p ˂ 0.0001, r²  = 0.108).

CONCLUSION

The PSQI has a significant association with the CAT and mMRC for COPD patients and is linked to the disease's severity.

Effects of metformin on autoimmune immunoglobins and interferon-γ in patients with early diagnosed pemphigus vulgaris: a prospective clinical trial

The management of pemphigus vulgaris (PV) is challenging. This study aimed to evaluate the immunomodulating effects of metformin on PV. The study was conducted in two phases: in the first phase, patients received routine first-line treatment (prednisolone plus azathioprine) for 2 months, then in the second phase, metformin was added to this regimen for another 2 months. After addition of metformin to the first-line medications, significant reductions were seen in serum IgG1 (reduced from 534.92 ± 134.83 mg/dL to 481.58 ± 130.46 mg/dL, P < 0.001), IgG4 (51.83 ± 27.26 mg/dL to 44.50 ± 26.05 mg/dL, P < 0.001) and interferon-γ (277.99 ± 108.71 pg/mL to 45.05 ± 17.080 pg/mL, P = 0.03) concentrations. The suppressant effect of metformin was greatest on IgG4 (coefficient of variation 1.28), the dominant subclass of IgG involved in PV. Metformin could have immunomodulating effects on PV with controlling effects on steroid complications.

Evaluation of the Drug Hypersensitivity Reactions Prevalence in Hospitalized Children in Sari City from 2014 to 2018: An Original Research

Background: Drug allergy is a subtype of Adverse Drug Reaction (ADR) mediated by the immunologic system. Extreme drug allergy is poorly known in children that contribute to hospitalization in our region. Objectives: This research aimed to study major drug hypersensitivity reactions in the north of Iran among the hospitalized children. Methods: This cross-sectional study was conducted at Bou Ali Sina Hospital in the north of Iran. We analyzed the medical files of 140 children admitted to the hospital with drug allergies from 2014 to 2018. The inclusion criteria were based on the DRESS (drug reaction with eosinophilia and systemic symptoms) scoring system, and those who scored more than four were enrolled. Patients with incomplete medical charts were excluded. The sampling methodology was based on the consecutive census method. Results: In the current study, 62 patients were females (44.29%), and 78 were males (55.71%). Ninety-six cases (68.57%) were children under five, and 44 cases (31.43%) were over five years old. Most ADRs were seen in patients from urban areas (58.57%) than in rural areas (41.43%). In 116 children (82.6%), maculopapular rashes were seen. Phenobarbital and cefalexin had the highest levels of drug reactions, including 85 persons (55.19%) and 18 persons (11.69%), respectively. Pruritus, fever, and scaling were the most common symptoms observed in the patients. The most commonly used treatment was antihistamines. Conclusions: The most causative medication inducing ADR was phenobarbital. The maculopapular rash was the most common skin manifestation, and there were no relationships between sex, age, medication type, and type of hypersensitivity reactions.

The Interrelationship between Liver Function Test and the Coronavirus Disease 2019: A Systematic Review and Meta-Analysis

Background

The outbreak of the coronavirus disease-2019 (COVID-19) has become a global public health challenge. Assessing the effect of COVID-19 on liver injury is of great importance. A systematic review and meta-analysis were conducted to establish the characteristics of liver function tests in COVID-19 patients.

Methods

A systematic search of publications from December 2019 up to April 2020 in Web of Science, Scopus, and Medline (via PubMed) databases was performed. Both cross-sectional and case series studies reporting an association between liver injury and COVID-19 infection were included. The data were analyzed using the STATA software (version 11.0) and the random-effects model for I2>50% was used to pool the results.

Results

In this meta-analysis, 42 articles comprising a total of 6,557 COVID-19 patients were studied. The prevalence of increase in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels was 30% and 21% in non-severe patients and 38% and 48% in severe patients, respectively. Patients with severe COVID-19 infection were 4.22, 4.96, and 4.13 times more likely to have elevated AST, ALT, and lactate dehydrogenase (LDH) levels, respectively.

Conclusion

Elevation in liver function tests was higher in patients with severe than non-severe COVID-19 infection. Given the widespread use of drugs that increases the risk of hepatotoxicity, healthcare providers should be aware of changes in liver enzymes in COVID-19 patients. The inclusion of other studies from outside China could confirm the pattern of elevation in liver function tests in COVID-19 patients across the globe. Preprint of this article is available on medRxiv, https://www.medrxiv.org/content/10.1101/2020.05.20.20108357v1.

Efficacy of viable BCG vaccine paste in the treatment of common warts: a double-blind randomized control trial

BACKGROUND

Treatment of common warts may be painful or leaves scars, mainly using traditional destructive methods. This study aimed to evaluate the efficacy of the viable Bacillus Calmette-Guérin (BCG) vaccine in paste formula as an immunotherapeutic modality for common warts treatment.

METHODS

This double-blind and randomized, parallel-group, placebo-controlled trial was conducted at the Ahvaz Imam Hospital Dermatology Department from November 2014 to 2015. Overall 80 patients with common warts in two groups (case and control) received BCG vaccine paste once weekly for eight consecutive weeks. Follow-up was done every two weeks during treatment and six months after the treatment to evaluate recurrence in patients with complete resolution.

RESULTS

In group A, eight patients (20%) had a complete response, 15 patients (37.5%) partial response, four patients (10%) low response, and 13 patients (32.5%) no response (p < .001). All patients in group B had no response to treatment (p < .001). After six months of follow-up, no recurrence was seen. Duration of disease less than 12 months (p = .001) and the number of lesions less than three (p = .01) were determining factors of response to treatment.

CONCLUSION

Topical BCG vaccine paste was an effective treatment for common warts, without recurrence and significant complications.

Translation and psychometric properties of the Persian version of the Health of the Nation Outcome Scales for Elderly People (HoNOS65+)

OBJECTIVES

This study aimed to evaluate the validity and reliability of the Persian version of Health of the Nation Outcome Scales for Elderly People (HoNOS65+) in Iran's elderly population.

METHODS

The scale English version translated to Persian using a forward and backward translation method. The scale was filled for two elderly population groups (inpatient and outpatients) (N = 300). Simultaneously with HoNOS+65, the Clinical Global Impressions Scale (CGI) was completed. Two separate therapists were filled HoNOS+65 for thirty-one patients (inter-rater reliability test). In general, content validity, consistency, confirmatory factor analyses (CFA), convergent validity, and criterion validity were examined.

RESULTS

Using exploratory factor analysis, three factors were extracted. Inter-rater reliability in some items has a slight agreement. Content validity ratio (0.75) and index (0.90) were calculated for each item. Cronbach's alpha total score was 0.82. According to the largest modification indices, CFA showed satisfactory fit indices. The convergent validity between HoNOS +65 and CGI was (r = 0/71, sig = 0.000). Finally, the optimal cut-off point was achieved 13. Sensitivity and specificity for the HoNOS +65 were 88.89% and 81.16%, respectively, with the Youden index of 0.7005.

CONCLUSION

The Persian version of HoNOS65+ has high reliability, validity, specificity, and sensitivity in multidimensional assessment of Iranian geriatric mental health.

Deep Vein Thrombosis Associated With COVID-19

The novel coronavirus disease 2019 (COVD-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The immunothrombosis could occur during infectionwith viruses. Deep vein thrombosis (DVT) is a devastating condition that usually involves the lower extremities. The typical course of DVT is associated with an episode of enormous limbswelling and pain. In this case report, we aimed to present one of the COVID-19 possible complications: DVT in a 38 years old man infected with SARS-CoV-2. A 38 years old manpresented with leg pain. He had a dry cough and fatigue suspicious symptoms of COVID-19. For further evaluations, the lung Computed Tomography scan (CT-scan), labratoricalassessments, and doppler sonography of the common femoral vein (CFV) of both legs were done. Also, for investigating the other underlying causes of DVT, abdominopelvic CT-scan andlumbosacral Magnetic Resonance Imaging (MRI) were done. The CT-scan showed GroundGlass Opacity (GGO) view. Labratorical assessment proposed a thrombotic condition. Thedoppler sonography of the CFV of both legs revealed a massive thrombosis in the left CFV suggesting an acute DVT. Abdominopelvic CT-scan and lumbosacral MRI were negativefor other underlying causes of DVT. COVID-19 is associated with the classical syndrome named disseminated intravascular coagulation and the subsequent consumption coagulopathypresented as DVT.

Development and Validation of the Knowledge and Attitude Scale Toward COVID-19 Pandemic Breaking Transmission Chain (KA-C) Among Iranian Population

Objectives: We aimed to develop a scale and evaluate this scale's validity and reliability to measure factors affecting people's knowledge and attitudes toward the pandemic breaking transmission chain. Methods: This exploratory mixed-method study was carried out in two phases: (1) item generation using literature reviews and interviews and, (2) item reduction by psychometric assessments of the developed scale. The face, content, construct (exploratory and confirmatory factor analysis), convergent, and discriminant validity of the scale were assessed in the Iranian population (n = 500) from March to June 2020. The Composite Reliability (CR) and the internal consistency correlation coefficient were estimated. Results: The Knowledge and Attitude Scale Toward COVID-19 Pandemic Breaking Transmission Chain (KA-C) among the Iranian population included 18 items. Two factors with a whole variance of 66.05% were identified by exploratory factor analysis. Factors were labeled as "health literacy" and "home health empowerment." The confirmatory factor analysis showed the goodness of fit. The CR of the scale for first and second factors were 0.965 and 0.833 receptively. The scale's internal consistency correlation coefficient was acceptable (Cronbach's alpha = 0.960 and 0.823, average interitem correlation = 0.643 and 0.635, McDonald's omega = 0.963 and 0.829, for the first and second factor, receptively). Conclusion: The KA-C scale can be exerted to screen the people's knowledge and attitude about the COVID-19 pandemic breaking the transmission chain as a valid and reliable scale for further policymaking, health care providers, and for a multi-dimensional psychosocial assessment of the pandemic period.

Ten-year-old boy with atypical COVID-19 symptom presentation: A case report

Since reactive arthritis (ReA) and urticaria could be seen in this age group along with atypical COVID-19 symptom presentation, pediatrics should be familiar with urticarial rashes and ReA in COVID-19 to enable early diagnoses of infected individuals.

The Effect of Orexin Receptor Antagonism on Quinpirole-Induced Compulsive-Like Checking Behavior in Rats

The orexinergic system supposedly plays a role in stress circuits for arousing behaviors during anxiety, suggesting that it may play a role also in neural circuits mediating the compulsive behavior characteristic of obsessive-compulsive disorder (OCD). This study aims to investigate the roles of the orexinergic system in the development of OCD behaviors, using as preparation the induction of compulsive checking by chronic treatment with the D2/D3 agonist, quinpirole. Repeated injections of quinpirole (0.5 mg/kg, twice per week for a total of 10 injections) were used to induce compulsive checking. In separate groups of rats, OX1R (SB334867-A; 10 μg i.c.v) and OX2R (TCS-OX2-29; 10 μg i.c.v) receptor antagonists were co-administered together with quinpirole. Checking behavior in a large open field was measured after the first, fifth, and tenth injections of the drugs. SB334867-A attenuated checking behavior and the level of anxiety. TCS-OX2-29 administration ameliorated anxiety but did not block the development of compulsive checking. Orexin 1 receptors seem to play a more critical role than orexin 2 receptors in the induction of compulsive checking. Considering that the quinpirole sensitization model of OCD involves activation of dopamine systems and sensitization to quinpirole, it is suggested that neural interaction between orexigenic and dopamine systems may be important in the pathogenesis of OCD.