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Background We aimed to investigate the association of initial chest CT scan findings with status and adverse outcomes of COVID-19 (including ICU admission, mortality, and disease severity). This retrospective cohort study was performed in three hospitals in Babol, northern Iran, between February and March 2020. Cases were confirmed by real-time polymerase chain reaction (RT-PCR). Clinical and paraclinical data of the patients were collected from their medical records. CT severity score (CSS) was calculated by a senior radiologist. Disease severity was determined based on the World Health Organization criteria. Results In total, 742 patients were included, of whom 451 (60.8%) were males and 291 (39.2%) were females. The mean age was 56.59 ± 14.88 years old. Also, 523 (70.5%) were RT-PCR-positive. Ground glass opacity was directly associated with RT-PCR positivity (odds ratio [OR] = 2.07). Also, RT-PCR-positive cases had significantly a higher CSS than RT-PCR-negative cases (p = 0.037). In patients confirmed with COVID-19, peribronchovascular distribution of lesions, number of zones involved, and CSS were associated with increased risk of ICU admission (OR = 2.93, OR = 2.10, and OR = 1.14, respectively), mortality (OR = 2.30, OR = 1.35, and OR=1.08, respectively), severe disease (OR = 2.06, OR = 1.68, and OR = 1.10, respectively), and critical disease (OR = 4.62, OR = 3.21, and OR = 1.23, respectively). Also, patients who had consolidation were at a higher risk of severe disease compared with those who did not (OR = 4.94). Conclusion Initial chest CT scan can predict COVID-19 positivity, ICU admission, mortality, and disease severity, specifically through CSS.

Objectives: Corticosteroids as the main treatment of hand eczema can cause major side effects. This study compared the effect of topical preparation of Sambucus ebulus L. leaves and hydrocortisone ...

Objectives: Developing a new medicine is a costly and time-consuming process. This study presents a novel method to collate a new materia medica from previously documented traditional Persian medicine (TPM) references. A well-documented materia medica will facilitate a quick and easy process to find traditional medicine for specific symptoms or diseases. Materials and methods: A nine-step algorithm is proposed to collate a new materia medica by searching and matching descriptions and references stated in various traditional Persian literature: (1) finding the equivalent of traditional description of symptoms or diseases; (2) determining the keywords to search in the references of TPM, including The Canon of Medicine (Book by Avicenna); (3) determining the best references of TPM for the aim of the study; (4) weighing up the references (a) based on the prominence of the author's prominence (b) determining whether the references are the author's own clinical findings or has citation from other scholars been used, (c) the popularity of the book that the references feature in, among other later scholars of TPM, the geographical and historical span across which the book has been distributed; (5) searching the references using keywords of symptoms or diseases; (6) finding the synonyms of terminologies in the various materia medicas and categorizing the findings; (7) revision (of references found) to ensure that nothing is neglected; (8) scoring the findings based on the defined criteria; (9) prioritization: sorting the materia medica based on the total scores. Some important economic, cultural or historical factors cannot be included in the main process of prioritization during the initial searching of the TPM materia medica. Therefore, it is necessary to take these factors into account after discovering the medicine and before using in practice to ascertain that they are a good match of a specific treatment, disease or symptom. Conclusion: A process to compile a new materia medica has been proposed which will enable the quick and easy selection of herbal treatments for various signs and symptoms of illnesses.

Background Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood mental health disorders. Stimulant drugs as the most commonly used treatment and first-line therapy for ADHD have side effects. One of the newest approaches to select the best choices and optimize dosages of medications is personalized medicine. Methods This historical cohort study was carried out on the data taken from the period of 2008 to 2015. Eligible subjects were included in the study randomly. We used mixed-effects logistic regression models to personalize the dosage of Methylphenidate (MPH) in ADHD. The patients’ heterogeneity was considered using subject-specific random effects, which are treated as the realizations of a stochastic process. To recommend a personalized dosage for a new patient, a two-step procedure was proposed. In the first step, we obtained estimates for population parameters. In the second step, the dosage of the drug for a new patient was updated at each follow-up. Results Of the 221 children enrolled in the study, 169 (76.5%) were male and 52 (23.5%) were females. The overall mean age at the beginning of the study is 82.5 (± 26.5) months. In multivariable mixed logit model, three variables (severity of ADHD, time duration receiving MPH, and dosage of MPH) had a significant relationship with improvement. Based on this model the personalized dosage of MPH was obtained. Conclusions To determine the dosage of MPH for a new patient, the more the severity of baseline is, the more of an initial dose is required. To recommend the dose in the next times, first, the estimation of random coefficient should be updated. The optimum dose increased when the severity of ADHD increased. Also, the results show that the optimum dose of MPH as one proceeds through the period of treatment will decreased.

Objective: This study strove to investigate the safety and effectiveness of Eryngo in the treatment of primary dysmenorrhea. Materials and methods: The researchers conducted a blinded, randomized, trial design on 169 women, 15–30 years of age, who had been diagnosed with primary dysmenorrhea at Babol University of Medical Sciences. Subjects were randomly assigned to receive 5 ml syrup of Eryngo, placebo, or Ibuprofen (200 mg) three times a day (15 ml/day), from one day prior to the onset of bleeding for five days. The degree of dysmenorrhea was reported by two measures; Visual analogue scale (VAS), as a primary outcome, and the assessment of dysmenorrhea severity (VMS), as a secondary outcome at 4 menstrual cycles: at pretreatment phase, at the first menstrual cycle, at the second menstrual cycle, and the third menstrual cycle without drug. Results: The reduced peak-pain differed by the treatment length in women treated for two menstrual cycles: 4.2 (1.0) cm in the Eryngo group, 4.3 (0.0) cm in the Ibuprofen group, and 0.9 (0.1) cm in the placebo group (P

Background Complementary and Alternative Medicine (CAM) have recently become more popular and accepted worldwide. One principal step to identify the status and organize strategies of CAM is evaluating the manner and the prevalence of its usage among people. This study aimed to investigate the prevalence of CAM modalities usage by the people of Babol, a central city in the North of Iran, in 2018. Methods Using the original International CAM Questionnaire (I-CAM-Q), a questionnaire was redesigned in Persian (Farsi) with some changes such as adding special modalities in Iran and its validity and reliability were assessed. Six hundred households were evaluated using a cluster sampling method in 2018 spring by 12 trained interviewers. Results Finally, 1770 questionnaires were correctly completed. A total of 110 participants (6.21% of the completed questionnaires) had visited CAM therapists in the last year, 109 persons (6.15%) had received prescriptions from physicians and paramedics to use CAM, and a total of 1032 people (58.30%) used herbs and herbal medicines in the last 12 months. Also, 1265 individuals (71.46%) had used CAM throughout their lives. The most popular methods were herbal medicine (65.76%), Persian Medicine (13.78%), water therapy (10.45%) and music therapy (8.36%). The use of CAM was more popular among women. Conclusions The general use of CAM in Babol was similar to other studies, but there were fewer visits by CAM therapists and less frequent adoption of common methods including homeopathy, acupuncture, and energy therapy. It was found that CAM was mostly used for non-serious diseases such as cold and transient gastrointestinal disorders, a pattern that is different from other studies in this field.

Introduction: COVID-19 is a viral disease of the coronavirus family. The virus first attacks the respiratorysystem and then infects important organs such as the heart, liver, brain, kidneys, blood and immune system.This study aimed to evaluate the effectiveness of a diet plan for lung diseases based on traditional Persianmedicine (PM) in patients with pulmonary dysfunction with possible infection with COVID-19.Materials and Methods: This study was performed as a randomized clinical trial in 2020 in the Sevome-Shaban Hospital and Shohada Gomnam Hospital in Tehran, Iran. In this study, patients admitted to thesehospitals were randomly entered into the study. A total of 80 people were included in this study. A normaldiet and a traditional medicine diet were considered for each group of patients. The effectiveness of the dietdesigned for patients was assessed in such a way that the primary outcome of changes in oxygen levels ofCovid 19 patients and the secondary consequences of the number of days of hospitalization and the degree ofchange in respiratory symptoms at discharge compared to hospitalization were examined. Also in this study,the general condition of patients including marital status, type of job, medical history, and drug use wereexamined. Patients enter the study after obtaining consent and will be excluded from the study at any time ifthey wish. Finally, the collected data were evaluated using G-Power. 3.1.9.2 software.Results: The results showed that there is a significant relationship between the use of diet based on traditionalmedicine and length of hospital stay, which has a correlation coefficient of 1.060 at the alpha level of 0.05.There is also a significant relationship between the use of diet based on traditional medicine and the amountof oxygen needed by patients at the alpha level of 0.05 has a correlation coefficient of 1.046. There is anothersignificant relationship between the use of diet based on traditional medicine and the rate of patients’ cough.At the alpha level of 0.05, it has a correlation coefficient of 1.451.Conclusion: According to the results, it can be concluded that the effective use of diet based on traditionalmedicine significantly increases the health of patients (reducing the length of hospital stay, reducing cough,and reducing the severity of oxygen demand in the study group (control In other words, the modified meanof these two groups in these three components (reduction of hospital stay, reduction of cough and reductionof the intensity of oxygen demand) were significantly different.

Background: The sensitivity to the radiation among human population depends on various parameters. This variation could lead to dissimilar outcome of radiotherapy in similar situations. Mizaj is a well-known term in Persian medicine that present an individualized medicine viewpoint. All of the people will be categorized in cold, moderate, and warm Mizaj. In this study, we aimed to evaluate the possible association between Mizaj and radiosensitivity by comet assay. Materials and Methods: Peripheral blood sample of 30 healthy volunteers (10 cold, 11 moderate and nine warm Mizaj) were taken and divided into two identical parts. The first part was exposed to 4 Gy x-rays, and the second part was regarded as the sham control. Then, DNA damages of samples were evaluated by the neutral comet assay. Results: The results showed that the mean percentage of damaged cells, in all of the irradiated groups including A (warm), B (moderate) and C (cold) was significantly higher than the controls (P

Bloating is a common gastrointestinal complaint which is difficult to treat.This study investigated the efficacy and compliance of a formulation called KAASER comprised of Trachyspermum ammi (L.) Sprague seed, Zingiber officinale Roscoe. rhizome and Piper nigrum L. berry in the treatment of functional bloating.A total of 106 patients with functional bloating, between 20 and 50 years of age, participated in this double-blind randomized controlled trial. Patients were divided into 3 parallel groups that received 500 mg of placebo, dimethicone or KAASER, three times a day for 2 weeks.The frequency and severity of bloating were primary outcomes, while the frequencies of eructation, defecation, borborygmus and early satiation were secondary outcomes. All parameters were evaluated at the beginning (week 0), and also weeks 2, 4 and 10 of the study, through self-report checklists with a scoring system.Among the 84 patients who completed the study, the frequency and severity of bloating (P 0.001), the frequencies of eructation, defecation and borborygmus (P = 0.03) were significantly improved in the group receiving KAASER (36 patients) compared with the dimethicone (35 patients) and placebo (35 patients) groups, during the 3 phases of follow-up. These significant differences persisted through the 2 and 8 weeks of follow-ups after cessation of medication (week 4 and 10). In early satiation, no significant differences were observed among the 3 groups.The results showed that KAASER can be effectively used to treat patients suffering from bloating. Bloating, eructation, defecation and borborygmus in the KAASER group remained significantly improved after 2 and 8 weeks of cessation of medication, making this mechanism an interesting area for further investigation.Registration trial IRCT2015100324327N on Iranian Registry of Clinical Trials.

Background: There are few effective drugs for pediatric functional constipation (FC). Objectives: Comparing the effectiveness of Cassia fistula’s emulsion (CFE) with Polyethylene glycol (PEG4000) in FC; and evaluation of safety of both drugs in the treatment of FC. Materials and Methods: A randomized open label, prospective, controlled, parallel-group clinical trial was carried on 109 children (M/F: 63/46; mean age ± SD: 59.7 ± 28.8 months) in Amirkola children’s hospital, Babol, Iran. The inclusion criteria were based on diagnosis of FC according to the Rome III criteria and age range between 2 - 15 years. They received CFE or PEG randomly for 4 weeks. Frequencies of defecation, severity of pain, consistency of stool, fecal incontinence and retentive posturing were compared between the two groups and with baselines. Children were counted as improved when they exited from Rome III criteria of FC. Results: Fifty seven patients were assigned to receive PEG and 52 patients received CFE. After 4weeks of medication, 86.5% of children in CFE group and 77.1% in PEG group (RR = 1.121, CI95%:0.939 - 1.338) exited from the criteria of FC. All measurable criteria improved in both groups without any significant difference, except in the frequency of defecation that in CFE group (10.96 ± 5.7) was significantly more than PEG group (6.9 ± 3.5) (P < 0.0001). Compliances of PEG were significantly better in the 2 first weeks (P = 0.002, 0.008) but not in third and fourth week (P = 0.061, 0.062). None of these two drugs cause clinically significant side effects. Conclusions: CFE can be as effective as PEG in the 4-weeks treatment of children with FC.

Objective: Bone is the most common site of metastasis in breast cancer. Prognostic factors for predicting bone metastases in breast cancer are controversial yet. In this study, we investigated clinical factors associated with secondary bone metastasis of breast cancer. Methods: In total, 1690 patients with breast cancer recorded between 2002 and 2012 in Motamed Cancer Institute, Tehran, Iran entered in the retrospective study. We studied age, menopausal status, histologic type, tumor size, number of cancerous axillary lymph nodes, serum concentrations of alkaline phosphatase (ALP), carcinogenicity antigen (CEA), cancer antigen (CA)-153, and hemoglobin (HB) in 2 groups with bone metastases (n = 123) and without it, respectively. We applied logistic regression to identify bone metastasis prognostic factors in breast cancer patients and calculated the cut-off value, sensitivity, and characteristics of independent prognostic factors using receiver operating characteristic (ROC) curve analysis. Results: Menopause, larger tumor size, and the greater number of cancerous axillary lymph nodes increased the chance of bone metastases significantly ( P .05). Logistic regression showed that age (odds ratio (OR) = 1.021), menopausal status (OR = 1.854), number of cancerous axillary lymph nodes (OR = 1.065), a tumor size between 2 and 5 cm diameter (OR = 2.002) and more than 5 cm diameter (OR = 4.009), and ALP (OR = 1.005) are independent prognostic factors associated with bone metastases. The ROC curve showed that the abovementioned factors have comparable predictive accuracy for bone metastases. Conclusions: Age, menopausal status, number of axillary lymph node metastases, tumor size, and ALP were identified as prognostic factors for bone metastasis in patients with breast cancer. So patients with these characteristics should be monitored more precisely with regular follow-ups.

Despite scientific advances, many of the treatments in male infertility remained indeterminate. In recent years, the attention to herbal remedies as an effective treatment for male infertility is considerable. We designed this study to determine the effects of Alpinia officinarum on the results of semen analysis in men with idiopathic infertility. In this clinical trial, seventy-six participants with idiopathic infertility were included in the intervention (plant treatment: n = 31; placebo: n = 29). Participants were randomised to take capsules containing dried extract of A. officinarum rhizome or placebo on a daily (total daily dosage of 300 mg) basis for 3 months. After 12 weeks of intervention, the sperm count and total number of spermatozoa with normal morphology were increased in participants treated with A. officinarum extract compared with the placebo group. The mean sperm count was initially 52 × 106 ± 24 × 106 /ml which changed to 71 × 106 ± 23 × 106 /ml, after intervention (p = 0.043). Also, the mean percentage of spermatozoa with normal morphology was 14.34% ± 9.16% before the treatment which significantly increased to 19% ± 14.89% (p