Iran Medical CouncilJournal of Iranian Medical Council2645-338X3420201001The Equity in Access to Coronavirus Vaccination; An Ethical, Scientific and Economic Rationale175176124953http://dx.doi.org/10.18502/jimc.v3i4.5186ENAhmadShamabadiPsychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, IranShahinAkhondzadehPsychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, IranJournal Article20200928https://www.jimc.ir/article_124953_2080b5fb4e23a49c522e5b32b0bc5477.pdfIran Medical CouncilJournal of Iranian Medical Council2645-338X3420201001Factors Associated with COVID-19 Morbidity and Mortality: A Narrative Review177186124961http://dx.doi.org/10.18502/jimc.v3i4.5188ENOmidDadrasDepartment of Health Informatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan0000-0001-9385-2170NazaninShahrokhniaGraduate School of Medicine, Shahid Beheshti University, Tehran, IranSarinaBorranGraduate School of Medicine, Shahid Beheshti University, Tehran, IranAliAsadollahi-AminIranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, IranSeyedAhmadSeyedAlinaghiIranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, IranJournal Article20200725Abstract<br />Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been declared as a pandemic on March 11th 2020 by the WHO. Morbidity and mortality of COVID-19 has been shown to be high among patients with underlying diseases. In this narrative review, searching a number of electronic databases (PubMed, Google Scholar, Scopus, and Science Direct), 127 related articles written in English were retrieved and of which 73 articles related to risk factors affecting morbidity and mortality of COVID-19 were extracted and summarized. Factors such as old age, male gender and working in health setting were associated with higher morbidity and mortality. Hypertension was the most frequent reported condition among those with severe disease. It also appeared to increase the mortality and duration of hospitalization. Diabetes, respiratory chronic illnesses (COPD, asthma), impaired liver and renal function, and malignancies were also mentioned as the risk factors for severe disease, longer hospitalization, poor prognosis and outcome. Some laboratory findings such as elevated D-dimer, CRP, and LDH as well as severe lymphopenia were associated with severity, mortality and poor outcomes in hospitalized patients. All in all, a considerable number of comorbidities and biomarkers are associated with severity and presentations of COVID-19 disease, affecting its morbidity and mortality rates. https://www.jimc.ir/article_124961_b3e4866a82db90d08ba9f6ea476f759c.pdfIran Medical CouncilJournal of Iranian Medical Council2645-338X3420201001Level of Adherence to GOLD Guidelines for Management of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Is There a Difference Between Patient Management in Different Hospital Wards?187192125048http://dx.doi.org/10.18502/jimc.v3i4.5189ENOmolbaninPaknejadShariati Hospital, Tehran University of Medical Sciences, Tehran, IranAkramShiriShariati Hospital, Tehran University of Medical Sciences, Tehran, IranZeinabNaderpourShariati Hospital, Tehran University of Medical Sciences, Tehran, IranJournal ArticleAbstract<br />Background: The purpose of this study was to evaluate the implementation of GOLD guideline in patients with an acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD). <br />Methods: In a cross-sectional study, all patients with COPD exacerbation referred to Shariati hospital from January 2014 to March 2015 were investigated. The level of adherence to GOLD guideline in three areas of hospital admission, therapeutic components of inpatient management (pharmacologic treatments, respiratory support) and discharge plan was assessed via reviewing patients’ medical profile. Each subject was classified as complete, non-complete and not evaluated in terms of adherence to the guideline.<br />Results: In this study, 125 patients with mean age of 67.64±1.71 years including 100 (80%) males were studied. Also, 104 and 21 patients were hospitalized in pulmonology and general medicine wards, respectively. In the present study, the adherence to GOLD recommendations for hospital admission, pharmacologic treatment and non-pharmacologic management were 92, 97.6 and 44.2%, respectively. Despite the high level of adherence to pharmacologic management, total adherence to non-pharmacologic interventions was poor.<br />Conclusion: Although high level of adherence to pharmacological management of COPD was observed, there was overtreatment particularly in case of antibiotics prescription. In addition, non-pharmacological management was not considered in over half of the patients. https://www.jimc.ir/article_125048_8a6a715e714d884b961f2166d297ea1b.pdfIran Medical CouncilJournal of Iranian Medical Council2645-338X3420201001The Effect of First- and Second-Line Antiretroviral Therapies on Lipid Profile of HIV/AIDS Patients193199125057http://dx.doi.org/10.18502/jimc.v3i4.5190ENMehrnazRasoolinejadIranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, IranAliAsadollahi–AminIranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, IranOmidDadrasDepartment of Global Health and Socioepidemiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan0000-0001-9385-2170AliehPourdastIranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, IranSyyedmohamadGhavamIranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, IranSeyedAhmadSeyedAlinaghiIranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, IranMasoudJafariIranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, IranMaliheHasannejadIranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, IranBanafshehMoradmand-BadieBlack Dog Institute, University of New South Wales, Sydney, AustraliaJournal Article20200808Abstract<br />Background: There has been a significant decrease in HIV-related mortality following the introduction of antiretroviral therapies. This increase in life expectancy has caused an increased risk of cardiovascular and metabolic diseases. Lipid metabolism could be affected by the virus itself or antiretroviral medications. In this study, an attempt was made to investigate the effect of first- and second-line HIV medications on lipid profile in HIV/AIDS patients.<br />Methods: The present study is a retrospective cohort study. The medical records of 66 AIDS patients older than 18 years, who referred to the Behavioral Counseling Center of Imam Khomeini Hospital during the years 2009 to 2014, were retrieved. The patients were assigned into two groups including first- (36 patients) and second-line (30 patients) treatment groups. To ensure that the patients’ baseline information was matched, demographic information and baseline lipid profile were compared between two groups and no significant difference was found between them. To examine and compare the effect of HIV medications on lipid metabolism, patients’ lipid profile at the baseline and 6 months after treatment was compared.<br />Results: The results showed that only triglyceride level was significantly affected by the type of HIV medication regimen (p <0.05). It was significantly higher in second-line medication group. Although the lipid profile (Cholesterol, HDL, and LDL levels) showed an overall increase over the course of treatment in both groups, it was not statistically significant.<br />Conclusion: In both groups, following antiretroviral medications (the first-and second-line), lipid profiles increased. Moreover, the triglyceride level was higher in second-line medications. Therefore, early screening and lipid lowering agents should be considered in HIV/AIDS patients receiving the retroviral medications in long term to prevent further cardiovascular complications. <br /><br />https://www.jimc.ir/article_125057_bf0968c5e9c318fe21d1659a15c119b8.pdfIran Medical CouncilJournal of Iranian Medical Council2645-338X3420201001Evaluation of the Safety of Ovarian Preservation at Early Stage of Endometrial Cancer in Premenopausal Women200204125062http://dx.doi.org/10.18502/jimc.v3i4.5191ENElhamShiraliDepartment of Gynecologic Oncology, Tehran University of Medical Sciences, Tehran, IranMitraModarres GilaniDepartment of Gynecologic Oncology, Tehran University of Medical Sciences, Tehran, IranFaribaYarandiDepartment of Gynecologic Oncology, Tehran University of Medical Sciences, Tehran, IranOmidHemmatianDepartment of Gynecologic Oncology, Tehran University of Medical Sciences, Tehran, IranAzarAhmadzadehDepartment of Gynecologic Oncology, Ahvaz University of Medical Sciences, Ahvaz, IranZohreKazemiDepartment of Gynecologic Oncology, Shahid Beheshti University of Medical Sciences, Tehran, IranMarjanGhaemiValie-Asr Reproductive Health Research Center, (VRHRC), Tehran University of Medical Sciences, Tehran, IranJournal Article20200503Abstract<br />Background: Endometrial cancer usually occurs at postmenopause stage of life but its incidence in younger patients is increasing in the last decades. The objective of the study was to evaluate the ovarian preservation in the early stage of endometrial cancer. <br />Methods: In this cross-sectional study, 174 patients with endometrial cancer who underwent Total Abdominal Hysterectomy (TAH) and Bilateral Salpingo-oophorectomy in 5 years were included. <br />Results: The results showed that 51.1% of the patients were at stage IA, 28.7% at stage IB, 6.9% at stage II, 11.5% at stage III and 1.7% at stage IV of endometrial cancer when they underwent surgery. One patient (1.12%) at stage IA of endometrial cancer, one patient (2%) at stage IB and one patient (8.3%) at stage II had micrometastasis in ovaries, and 8 patients (40%) at stage III and 2 patients (66.6%) at stage IV had micrometastasis and co-existing tumor. <br />Conclusion: In conclusion, findings revealed the high safety of ovarian preservation in endometrial cancer at earlier stages of the endometrial cancer with low risk of ovarian involvement.<br /><br />https://www.jimc.ir/article_125062_b764fec32f7620bb829c61f45207c273.pdfIran Medical CouncilJournal of Iranian Medical Council2645-338X3420201001The Relationship between the Type of Milk Consumed and the Risk of Kidney Stones in Children Under Two Years of Age205210125065http://dx.doi.org/10.18502/jimc.v3i4.5192ENHamidehShajariDepartment of Neonatology, Shariati Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IranAhmadShajariDepartment of Pediatrics, Islamic Azad University of Medical Sciences, Yazd, IranMohammadGolshan TaftiDepartment of Pediatrics, Islamic Azad University of Medical Sciences, Yazd, IranRezaSamaninejadDepartment of Pediatrics, Islamic Azad University of Medical Sciences, Yazd, IranJournal ArticleAbstract<br />Background: Kidney stones are one of several serious health problems in childhood that cause nutritional and growth disorders, and may finally lead to chronic kidney failure in this group.<br />Methods: In this analytical study conducted through a case-control design, 30 children under the age of two with kidney stones, and 125 children of the same age and sex without stones were studied. Patient information including personal profile and the results of some necessary tests were extracted from patient records and listed in a checklist. The data was analyzed using SPSS (Version 17.0). Statistical significance was considered when p-value was <0.05.<br />Results: In terms of duration of breastfeeding, a significant difference was observed between the patients with stones and patients without stones; the duration of breastfeeding was longer in the control group (p=0.003). In addition, the duration of feeding with formula milk and cow milk was longer in the case group (p=0.038 and p=0.012, respectively).<br />Conclusion: Breastfeeding can serve as a nutritional factor that plays a preventive and protective role against the formation of kidney stones in infants.<br /><br />https://www.jimc.ir/article_125065_31b5cbadca64144edad8f66acfbdd4ee.pdfIran Medical CouncilJournal of Iranian Medical Council2645-338X3420201001Fighting COVID-19; Governments or the Masses?211213125066http://dx.doi.org/10.18502/jimc.v3i4.5193ENRahimBadrfamDepartment of Psychiatry, Roozbeh Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran0000-0001-9808-1678AtefehZandifarCardiovascular Research Center, Shahid Rajaei Educational & Medical Center, Alborz University of Medical Sciences, Karaj, IranSocial Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran0000-0002-4725-1734Journal Article20200920Since the identification and global spread of COVID-19 in Wuhan, China to date (1 September 2020), more than 26,506,670 people worldwide have been infected with the disease and more than 876,677 people have died of the disease (1). Observing what has happened during this period and paying attention to the way governments have dealt with this recent situation in the long run have raised serious concerns about slow and late steps of governments from the beginning of the spread of the disease (2).https://www.jimc.ir/article_125066_61249dad1b96f71371fce6f8fb91715f.pdfIran Medical CouncilJournal of Iranian Medical Council2645-338X3420201001Non-Pharmacological Interventions to Improve Quality of Sleep during COVID-19 Pandemic214215125068http://dx.doi.org/10.18502/jimc.v3i4.5194ENMir FarhadGhalehbandiMental Health Research Center, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, IranFahimehSaeedDepartment of Psychiatry, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IranFatemehKashaninasabMental Health Research Center, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, IranJournal Article20201002During COVID-19 pandemic, factors such as incidence of uncontrollable conditions, uncertainty of the future, and changes in daily life patterns affect the mental and physical health of individuals. Anxiety, depression, and stress caused by the pandemic can significantly change the quality of sleep in people. Some studies have shown that young women, individuals with high levels of fear of COVID-19, and people with a history of psychiatric problems are expected to experience sleep problems such as insomnia more severely. Poor sleep can weaken the immune system and make individuals more vulnerable to viral infections. Under these conditions, optimal sleep patterns can help regulate mood, improve brain function, and boost energy during the day. However, maintaining good health is not an easy task in quarantine conditions due to the limitations in social communication and sedentary lifestyle (1,2).<br />The focus of this letter is on mental health of staff, general practitioners, and sleep specialists to educate their patients and people in the community about how to improve quality of sleep and deal with sleep problems during COVID-19 pandemic. The following are some typical suggestions to overcome the negative effects of the current pandemic:https://www.jimc.ir/article_125068_0698344448a317f5be33e6b6f6025a6a.pdfIran Medical CouncilJournal of Iranian Medical Council2645-338X3420201001COVID-19 and Psychosomatic Care in the Largest General and Academic Hospital in Iran216218125069http://dx.doi.org/10.18502/jimc.v3i4.5195ENAhmad AliNoorbalaDepartment of Psychiatry, Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0002-7798-1682RahimBadrfamCardiovascular Research Center, Shahid Rajaei Educational & Medical Center, Alborz University of Medical Sciences, Karaj, Iran0000-0001-9808-1678AtefehZandifarCardiovascular Research Center, Shahid Rajaei Educational & Medical Center, Alborz University of Medical Sciences, Karaj, IranSocial Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran0000-0002-4725-1734Journal Article20200928During the relatively short period of COVID-19 pandemic, we have witnessed numerous psychiatric and psychosomatic problems among patients with this disease and different groups of people and health care staff (1). Growing concerns about the uncertainty of the situation, along with fear and changes in biological rhythm, have played an important role in the formation of psychosomatic symptoms associated with this disease (2). In addition, increased depression and anxiety and decreased quality of life and well-being in different parts of the world, compared to the time before the recent pandemic, have been reported (3).https://www.jimc.ir/article_125069_f2f5fa29e5fc1334eaba2c98f2342e24.pdf