Review Article


Comparison between Management and Pharmacotherapy of COVID-19 in Iran and Switzerland

Payam Peymani, Somaye Bazdar, Leila Zarei, Mehdi Hoorang, Nazafarin Hatami-Mazinani, Kamran B Lankarani, Ali Reza Salili, Fatemeh Dehghani, Farshad Bargrizaneh, Sara Moghaddam, Maryam Matouri, Shima Jafari, Seyyed Amirreza Saghi, Hamed Delam, Motahareh Mahi-Birjand

Novelty in Biomedicine, Vol. 10 No. 4 (2022), , Page 219-225
https://doi.org/10.22037/nbm.v10i4.38215

Background: On 30 January 2020, the WHO declared the outbreak of SARS-CoV-2 as a public health
emergency. In the present study, we compared the preventative and therapeutic strategies and the success rates of Iran and Switzerland during the COVID-19 outbreak.
Materials and Methods: This study was conducted using electronic databases such as PubMed, Scopus, and
Web of Science. In addition, the official documents of developed countries and WHO from 1st February until 15th May 2020 were studied. Relevant documents were reviewed in detail, and vital data were extracted.
Results: Both countries have restriction policies to reduce the infection rate in the prevention setting. These
policies, such as the recommendation to all citizens to stay home unless necessary, army participation, and
non-face-to-face counseling, were surveyed by similar techniques in both countries. Some policies were
implemented in both countries with different protocols. These policies, including social distancing practices,
smart distancing methods, business activities, border closures, border controls, and restrictions, travel
restrictions, testing and screening for infection and fever, and decreased working hours, were performed in
both countries. In the treatment setting, the therapeutic strategy used in Iran consisted of hydroxychloroquine
or chloroquine phosphate and anti-viral drugs. Switzerland followed the guidelines of the European countries.
The infection rate, recovery rate, and death rate were 0.139%, 78.73%, and 5.91% in Iran, while these rates
were 0.352%, 88.81%, and 6.15% in Switzerland, respectively.
Conclusion: Due to the lack of special treatment for the disease, prevention must be considered the most
important factor in policymaking. Importantly, observing social distance is the most effective method among
the preventative strategies. The capacity of the health care systems to provide optimal services and facilities is
an important factor for patients recovery.

Impact of educational interventions on the prevention of emerging diseases: A systematic review

Soleiman Ahmady, Amin Habibi, Nilofar Massoudi

Novelty in Biomedicine, Vol. 10 No. 4 (2022), , Page 255-260
https://doi.org/10.22037/nbm.v10i4.38571

Background: Seasonal influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could
cause considerable morbidity and mortality. The present study investigates the effectiveness of educational
interventions to prevent these diseases.
Materials and Methods: We searched PubMed/Medline, Embase, and Cochrane Controlled Register of Trials
(CENTRAL) for relevant clinical studies up to March 25, 2022. The following terms were used: “influenza”,
“flu”, “respiratory infection”, “prevent”, "severe acute respiratory syndrome", COVID-19 “intervention”,
“education”, “school-based”, and “inform”.
Results: Out of 1296 studies retrieved from databases, 13 types of clinical trials met the inclusion criteria and
were included in the study. E-learning and the educational module were the most common interventions for
influenza and COVID-19, respectively. The measured outcomes were health promotion strategies and
preventive behaviors among participants. All except one article showed a significant association between
educational interventions and outcomes.
Conclusion: The included studies in the current systematic review indicated the efficacy of health promotion
educational interventions in improving knowledge and preventive behaviors regarding COVID-19 and
Influenza.

Original Article


A preliminary case series comparison of chest computerized tomography scan and Polymerase Chain Reaction (PCR) for COVID-19 contact tracing in developing countries with limited resources

Hooman Bahrami-Motlagh, Amir Mohammad Papan, Zahra Sahraei, Babak Salevatipour, Maryam Haghighimorad, Alireza Karami, Mana Zaman, Rastin Radfar, Minoosh Shabani

Novelty in Biomedicine, Vol. 10 No. 4 (2022), , Page 207-212
https://doi.org/10.22037/nbm.v10i4.37938

Background: Imaging and PCR each have a role in detecting and implementing precautionary measures in
isolating individuals with a history of close contact, which helps limit the COVID-19 pandemic. Due to
developing countries' difficulties, PCR is limited in Iran. This study seeks to determine the feasibility of early
low-dose chest computed tomography (CT) scans substitution with PCR.
Materials and Methods: Asymptomatic participants with a history of close contact with a confirmed case of
COVID-19 were enrolled and followed for one week, receiving 2 PCR tests within one week. Initially, a chest
CT scan was performed. The second CT scan was performed within one week on two participants. Participants
with an initially negative CT scan and participants with a first CT scan compatible with COVID-19 who became
symptomatic.
Results: All Participants had an RT-PCR and at least one CT scan. Positive RT-PCR results were reported in
6 and 9 participants initially and within one week, respectively. Chest CT scans favoring COVID-19 infection
were initially reported in 4 and 6 participants within one week, respectively. Seventeen participants showed
neither symptoms nor positive RT-PCR or chested CT scans favoring COVID-19. Thirteen participants either
had positive RT-PCR, a COVID-19 chest CT scan or became symptomatic.
Conclusion: Rapid detection of COVID-19 and subsequent quarantining is crucial in the global fight against
this pandemic. Our results showed lower sensitivity for chest CT scans compared to COVID-19 PCR,
suggesting that chest CT scans are unsuitable for COVID-19 PCR tests.

A Randomized Controlled Trial: Colistin Alone or Colistin and Meropenem: Which Is More Effective for the Management of Urinary Tract Infections?

Davood Yadegarynia, Shabnam Tehrani, Amirreza Keyvanfar, Latif Gachkar, Behnaz Najafi

Novelty in Biomedicine, Vol. 10 No. 4 (2022), , Page 213-218
https://doi.org/10.22037/nbm.v10i4.38197

Background: Colistin is a common antibiotic used to treat urinary tract infections (UTIs) caused by gramnegative bacteria. In recent years, due to the increasing resistance, consumption of colistin alone could lead to
treatment failures. This study aimed to compare the effectiveness of colistin alone with colistin and meropenem
to treat patients with urinary tract infections.
Materials and Methods: In this randomized, open-label, parallel groups controlled trial, hospitalized patients
with urinary tract infections were included. Patients were randomly allocated to the control group (n=35) that
received colistin (1 mIU every 12 hours) and the intervention group (n=35) that received colistin (1 mIU every
12 hours) with meropenem (1gr every 8 hours). An infectious disease specialist evaluated the therapeutic
responses 48-72 hours after admission. Cessation of fever, improvement of symptoms and signs, and negative
urine culture within 48 hours were considered successful therapeutic responses.
Results: The mean length of hospitalization was longer in the control group (4.74±0.78 days) compared with
the intervention group (4.26±0.56 days) (P=0.004). The prevalence of fever cessation had no significant
difference between the two groups at any time (P>0.05). Also, there was no significant difference between
the two groups at any time, considering vital signs, irritative urinary symptoms, nausea and vomiting, and
flank pain (P>0.05).
Conclusion: The administration of colistin and meropenem to treat UTIs was associated with a shorter
length of hospital stay. However, regarding response to treatment, it did not matter if they were treated with
colistin alone or with combination therapy (colistin and meropenem)

SARS-CoV-2 IgG and IgM Analysis in Patients Who Attended a University Hospital During the COVID-19 Epidemic in Iran

Fariba Fayaz , Foad Rommasi, Leila Atefmehr , Mohammad Javad Nasiri

Novelty in Biomedicine, Vol. 10 No. 4 (2022), , Page 226-231
https://doi.org/10.22037/nbm.v10i4.38313

Background: The world is facing a new coronavirus that causes a respiratory infection called COVID-19.
Therefore, there is an increasing request for antibody tests in recovered individuals since they want to evaluate
their immunity against SARS-CoV-2 reinfection.
Materials and Methods: In our study, we had 1000 blood samples from patients admitted to the Ghiassi Hospital,
Tehran, Iran, or were asked to perform serological SARS-COV-2 IgM and IgG tests by their physicians were
collected. The antibody levels were assessed via the ELISA assay method using S and N antigens during various
waves of the COVID-19 epidemic in Iran.
Results: The highest IgG level (2.77) compared to the average (with 95% confidence) is observed in patients
infected in the third wave, which is confirmed by the ANOVA test. The mean IgM concentration in the second
wave was equal to 0.77 and more than the IgM level in the third wave and the beginning of the fourth wave,
which was confirmed by the ANOVA test.
Conclusion: Detection of SARS-COV-2 IgG, IgM has significant potential for evaluating the severity and
prognosis of COVID-19. In addition, all seroepidemiology data in each community can help Health
Commissions for controlling this pandemic. These data also can be used for epidemiological modeling and
assessing the prevalence of COVID-19 immunity in society.

Background: Emergence reactions are common after general anesthesia with tracheal intubation and can be
associated with severe hemodynamic consequences. Inflating the cuff with local anesthetic instead of air has been reported to prevent these problems. However, no definitive results have been obtained for the effectiveness of this method. This study tried to come to a more reasonable conclusion by conducting more studies, and we used a variety of local anesthetics.
Materials and Methods: This study was performed on 350 patients over 18 years undergoing general anesthesia using an endotracheal tube. Patients were divided into five groups based on endotracheal tube cuff inflation with lidocaine, ropivacaine, bupivacaine, isotonic saline, and air. After removing the endotracheal tube, patients were evaluated for cough, sore throat, and hoarseness.
Results: Cough, sore throat, and hoarseness were observed in 43.7%, 27.4%, and 4.6% of cases, respectively.
At all measured times, all reactions in all local anesthetic groups were weaker than in the air and saline groups.
The difference between the local anesthetic groups was not significant.
Conclusion: Using local anesthetics to inflate the endotracheal cuff reduces the incidence of emergence
reactions from general anesthesia.

Background: Colorectal cancer (CRC) ranks third in cancer prevalence. Lactobacillus casei, a probiotic
bacterium, can optimize the microbiota population of the gastrointestinal tract and prevent the growth of harmful bacteria that induce carcinogenesis. In this study, we investigated the effect of L. casei acidic proteins on apoptosis in the SW480 cell line to identify a drug protein for treating CRC.
Materials and Methods: We assayed the effect of the isolated acid-resistant proteins of the Chaperonin
bacterium, a metal-dependent Hydrolase, and Lysozyme on the SW480 colorectal cancer cell line apoptosis
pathway gene expression with a Real-Time RT-PCR.
Results: All three proteins induced apoptosis in the cells treated separately with each of the proteins. The
results showed that the up-regulation of BAX and P53 gene expression and the apoptosis pathway were
significantly induced. Also, BCL2 expression was down-regulated, and significant anti-apoptotic was observed
at p<0.0001. Moreover, the cells treated with these three proteins down-regulated the expression of MAP2K1
and provoked the opposite apoptosis pathway.
Conclusion: Our results found that these proteins would be a good choice for potential CRC treatment.

Background: Radiation-induced dermatitis (RID) is a common side effect of radiotherapy. The present work
attempts to examine the effect of using henna- violet based topical preparation to prevent and decrease the
severity of RID in patients with breast cancer.
Materials and Methods: The study was carried out as a prospective, double-blind clinical study on 43 breast
cancer patients aged 18-75 years. The subjects had undergone breast-conserving surgery, and radiotherapy was scheduled for them. The participants were categorized randomly into two groups; patients who received the henna- violet based topical preparation and patients who received a placebo twice a day for six weeks. The level of the RID score was measured every week based on the toxicity criteria of the radiation therapy oncology group (RTOG).
Results: The henna- violet based topical preparation decreased the severity of RID and delayed the
development of grade 2 RID for two weeks. In addition, the initiation of grade 3 RID was deferred for one
week. There was a significant decrease in grade 2 RID (20% vs. 56.52%) as well as grade 3 RID (10% vs.
26.09%) in the patients who received the henna- violet based topical preparation at the end of the 6th week
(P=0.004).
Conclusion: This cream, which contained henna and violet, had no severe adverse effects, could prevent RID
and decreased the grade of dermatitis in breast cancer patients compared to the placebo.