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Context: Coronavirus disease 2019 (COVID‑19) has been revealed as a severe illness with a wide‑ranging cardiac manifestation and has a worldwide burden on the health‑care system. Aims: Our aim in this study is to assess the impact of mild COVID‑19 infection on cardiac function in patients without previous structural heart disease. Settings and Design: We evaluated 100 outpatients with a history of mild COVID‑19 infection without needing hospitalization within 3 weeks to 3 months after recovery from the acute phase of the illness between August 2020 and July 2021. Subjects and Methods: The patients were compared with 105 healthy participants without a history of COVID‑19 as the control group. All participants underwent comprehensive transthoracic echocardiography. Statistical Analysis Used: Data were analyzed using IBM SPSS statistics 23. For all tests, P < 0.05 was defined as statistically significant. Results: COVID‑19 patients had higher global longitudinal strain (P = 0.001), systolic pulmonary artery pressure (P = 0.008), RV E’ (P = 0.049), and RV A’ (P = 0.003), while had lower septal tissue velocities (P = 0.01) and left ventricular ejection fraction (EF) (LVEF) (P = 0.03). Abnormal EF (LVEF <55%) was noted in 19% of the COVID‑19 patients and 8.6% of the control group (P = 0.03). Moderate or more diastolic dysfunction was noted in 10 COVID‑19 patients but only in one participant in the control group (P = 0.005). Conclusions: Mild COVID‑19 infection can result in cardiac functional and structural changes, even in patients without known previous structural heart disease. Echocardiography can be a useful modality for risk assessment and follow‑up in patients with COVID‑19. [ABSTRACT FROM AUTHOR]

The high prevalence of HIV infection and the deaths caused by it is one of the challenges for the healthcare systems throughout the world. In this study, we analyzed the survival of people living with HIV and co-infections, and related factors. This retrospective cohort study was performed on 3030 people living with HIV admitted to Imam Khomeini Behavioral Disease Counseling Center, Tehran, Iran, during 2004–2018. Required data were obtained from the individuals' files. Kaplan Meier diagrams and Log-rank tests were used to assess the relationship between different factors and survival. In addition, Cox regression analysis was performed to determine the effective factors in HIV mortality. Data were analyzed using STATA software, version 14. The mean age of studied population was 43.2 ± 9.5 [years] and 77.3 % were male. Among the subjects, 3.2 % were infected with hepatitis B, 31.5 % with hepatitis C, and 13.9 % with Tuberculosis (TB). One, five, ten, and fifteen-year survival rates were 97.0 %, 93.0 %, 86.0 %, and 54.0 %, respectively. The mean survival time was 154.2 ± 0.9 months. Age more than 35, history of imprisonment, Unsafe sexual behavior, TB, and hepatitis C are independently associated with death in people living with HIV (p < 0.05). The survival of people living with HIV in the present study was in the favorable range compared to previous studies. However, co-infection with hepatitis C was associated with reduced survival of the subjects in this study. Therefore, it is suggested to detect and then prevent and control HCV co-infection to increase the survival of subjects. [ABSTRACT FROM AUTHOR]

Malnutrition is prevalent in upper gastrointestinal cancer patients. The purpose of this study was a comprehensive assessment of nutritional status in newly diagnosed patients with esophageal cancer. Newly diagnosed esophageal cancer patients were referred to a chemo-radiation referral center in Mashhad, Iran, between February 2017 to February 2019. Anthropometric indices, a Patient-Generated Subjective Global Assessment (PG-SGA) tool, body composition, dietary intake, nutritional-related complications, and laboratory tests were assessed. One hundred and eighty-nine patients with a mean age of 67.1 ± 12 and a male to female ratio of 98 to 91 were included. Ninety-seven (51.3%) of patients had experienced significant weight loss and 56 (29.6%) were underweight at diagnosis. According to PG-SGA, 179 (94.7%) needed nutritional interventions. Reduced muscle mass and low handgrip strength were observed in 70 (39.4%) and 26 (14.4%) of patients, respectively. Inadequate intakes of energy (less than 24 kcal/kg/day) and protein (less than 1.2 g/kg/day) were found in 146 (77.8%) and 171 (91%) patients, respectively. The mean total daily energy and protein intakes of subjects were 943.8 ± 540 kcal/day, and 30.6 ± 21 g/day, respectively. The most common nutritional-related complications were as follows: dysphagia (84.8%), anorexia (31.6%), constipation (62.1%), esophageal pain (48.4%), and dyspepsia (41.1%). Our study demonstrated a high prevalence of malnutrition in newly diagnosed esophageal cancer patients. This fact demonstrates the importance of early screening of nutritional status via PG-SGA tool, clinical evaluation, dietary intake evaluations, and laboratory tests, based on which effective nutritional interventions and Symptoms management may be introduced in these patients. [ABSTRACT FROM AUTHOR]

Abstract Background and purpose This systematic review and meta-analysis aimed to assess the effects of vitamin D supplements on indices of glycemic control [homeostatic model assessment-insulin resistance (HOMA-IR), hemoglobin A1C (HbA1C), fasting blood glucose (FBG), and quantitative insulin-sensitivity check index (QUICKI) and lipid profile in diabetic patients. Methods Eight databases were searched, for randomized controlled trials (RCTs) or cross-sectional and cohort studies that have been published up to December 2017. We used the comprehensive meta-analysis (CMA) software for all statistical analysis and used the I2 index for assessing heterogeneity. A p value of <0.05 was considered as statistically significant. Results We found 621 articles, and after the exclusion of ineligible publications, 82 studies remained to be assessed of which 37 were used for meta-analysis. Vitamin D supplementation was associated with a significant improvement in FBG (p = 0.001 and 95% CI: −0.526 to −0.136) and HbA1C (p = 0.003 and 95% CI: 1.719 to −0.361) in individuals with type 2 diabetes mellitus (T2DM); while in women with gestational diabetes mellitus (GDM) the reduction in FBG (p = 0.071 and 95% CI: −0.873 to −0.035) and HbA1C (p = 0.199 and 95% CI: 3.270 to 0.681) failed to reach statistical significance. Treatment with vitamin D supplements was associated with an improvement in HOMA-IR in pregnant diabetic women (p = 0.028 and 95% CI: 0.924 to −0.053) and for individuals with diabetes mellitus (p = 0.005 and 95% CI: 1.772 to −0.319). The pooled result of the cross-sectional meta-analysis indicated that serum vitamin D concentrations were significantly lower in diabetic patients than in healthy controls (p = 0.018 and 95% CI: 0.587 to −0.054). Conclusion This meta-analysis suggests that vitamin D supplementation improves indices of glycemic control (FBG, HOMA-IR, and HbA1C) in patients with diabetes mellitus. Hence, vitamin D supplements may be of potential therapeutic value in diabetic patients, as an adjuvant therapy along with other treatments. [ABSTRACT FROM AUTHOR]

Highlights • Low level laser therapy helped to alleviate the pain and significantly reduce the clinical signs of oral lichen planus assessed by physicians. • Low level laser therapy is as effective as pharmacological methods in treating oral lichen planus without demonstrating the adverse effects that are associated with those treatment methods. • Photodynamic therapy failed to show any significant effect on treating the signs of OLP. Abstract Background Oral lichen planus (OLP) is a chronic immune-mediated disorder that inflicts oral mucosa in 0.5–2% of the population. Surgery, photodynamic therapy, laser therapy and most commonly pharmacological therapy (like corticosteroids) has been used for treating OLP. New phototherapy approaches have been shown to have positive effects on treating some oral lesions and the aim of our study was to assess the effects of different phototherapy treatments on OLP. Methods We conducted a comprehensive electronic search using the determined search strategy in MEDLINE, EMBASE and CENTRAL electronic databases. A hand search of the reference list of the relevant studies and related systematic reviews was also performed. Results For low-level laser therapy, before and after studies showed a significant difference in pain (MD = −4.39, CI = 95% −4.83, −3.96) and sign score (MD = −1.86, CI = 95% −2.53, −1.19) after treatment. The comparison between corticosteroid therapy and LLLT also showed a significant difference in their effects for severity (MD = 0.57, CI = 95% 0.04, 1.09), but no differences in sign (MD = 0.21, CI = 95% −0.83, 1.24)and pain (MD = −0.10, CI = 95% −0.57,0.38) score was found between these two methods. Before and after studies of photodynamic therapy did not reveal any differences in lesion size. (MD = −1.95, CI = 95% −4.39, 0.490). Conclusion Low-level laser therapy seems to be a reliable alternative to corticosteroids for treating OLP without the adverse effects associated with the pharmacological method. No conclusive evidence for the effectiveness of photodynamic therapy in treating OLP lesion exists. [ABSTRACT FROM AUTHOR]

The reported effects of vitamin D on anthropometric indices have been inconsistent. This meta-analysis was conducted in order to assess the impact of vitamin D fortified food on weight, body mass index (BMI), fat mass, waist circumference (WC), hip circumference (HC) and waist to hip ratio (WHR). PubMed/Medline, ISI Web of Knowledge, ScienceDirect, Scopus, Cochrane Library and Google Scholar were searched up to the end of 2019. We selected only randomized controlled trials in which vitamin D fortified food was used as the intervention, and a regular diet was used in the control group. Vitamin D fortified products appeared to have a significant effect on WC (MD: -1.283; 95% CI,-1.892 to -0.674) and WHR (MD: -0.020; 95%CI: -0.035 to -0.004). This meta-an-alysis showed that whilst a diet containing vitamin D fortified foods does not reduce body weight or BMI, it has beneficial effect on WHR and WC. • The meta-analysis showed that consuming vitamin D fortified food could be effective in reducing WC and WHR more than weight. • If the intervention period with vitamin D fortified food is maximum of 6 months, it would be associated with weight gain. • There are no beneficial effects of consuming Ca+ vitamin D (vs. vitamin D alone) fortified food on anthropometric indices. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) is a sexually transmitted virus and related to the development of cervical cancer (CC). To determine the association between high-risk HPV types and CC, we undertook a systematic review and meta-analysis of recently reported prevalence of HPV16 and 18 in Iranian women identified with cervical infections. Prevalence studies were identified between 2002 and 2018 using several databases including Medline, Web of Science, Embase, Google Scholar, Iranmedex, and Scientific Information Database. For patients with CC, 57% (95% confidence interval [95% CI] = 43.7%-70.4%) were HPV positive, 48.5% (95% CI = 31.8%-65.2%) were HPV16 and 12.5% (95% CI = 8.8%-16.2%) were HPV18 positive. The results from meta-analysis indicate a relatively high prevalence of high-risk HPV among women infected with CC. [ABSTRACT FROM AUTHOR]