Background: The safety of health-care workers (HCWs) during the COVID-19 pandemic is a major concern worldwide. Dermatological problems due to personal protective equipment are annoying issues. We aimed to evaluate dermatological adverse events following the use of these protections in HCWs managing COVID-19 patients. Materials and Methods: One hundred and fifty-six workers managing COVID-19 patients were enrolled in this cross-sectional study. We conducted face-to-face interviews to collect the data and focused mainly on protection type and mucocutaneous symptoms with new onset or exaggeration after this equipment. Results: Dermatological problems following protective equipment usage occurred mainly during the 1^st week (65.4%). The most common site of skin involvement was the nose (82.7%) and the most frequent visible complaints were the pressure effect and erythema on the nose in 80.8% and 57.7% of cases, respectively. There was a significant association between mask type and facial skin problems (P < 0.001). The main symptoms were itching (21.8% scalp, 39.1% face and body) and burning sensation (14.1% scalp, 23.7% face and body). Skin desquamation (37.2%) and dorsal hand dermatitis (41.66%) were significantly more frequent in atopic participants (P = 0.02 and P = 0.01, respectively). Hand involvement was significantly associated with frequency of hand washing (odds ratio = 1.97, 95% confidence interval = 1.04–3.74, P = 0.03). Conclusion: We found that skin problems related to protective equipment were common and frequently located on the face mainly due to facial masks. These complications should be prevented by proper use of this equipment.

Background: The main aim of the present study is to investigate the independent association objectively measured level of physical activity (PA) and serum concentration of liver aminotransferases (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]) among seemingly healthy individuals. Materials and Methods: The current secondary study was conducted in the framework of Khuzestan Comprehensive Health Study, a large population-based multicentric cross-sectional study, conducted between 2016 and 2019 on 18,966 individuals living in Khuzestan province, southwestern Iran. International PA Questionnaire was used for evaluating PA levels, and participants were divided into three groups: low, moderate, and high PA, and ALT and AST were compared between these groups. Results: The mean ± standard deviation age of participants was 38.65 ± 11.40 years. The majority of participants were female (71%). The mean concentration of ALT in total sample was 18.22 ± 13.06 (male: 23.65 ± 16.26 and female: 15.57 ± 10.06), while the mean concentration of ALT in total sample was 19.61 ± 8.40 (male: 22.44 ± 10.03 and female: 18.23 ± 7.08). A statistically significant inverse correlation was found between AST (r = −0.08, P = 0.02) and ALT (r = −0.038, P < 0.001) with total PA score. The mean concentration of ALT was 19.96 ± 13.63 in people with low PA, 17.62 ± 12.31 with moderate PA, and 18.12 ± 13.47 with high PA (P < 0.001). The mean concentration of AST in total sample was 20.37 ± 8.85 in people with low PA, 19.21 ± 8.83 with moderate PA, and 19.75 ± 8.85 with high PA (P < 0.001). The difference between people in different levels of PA in terms of mean concentration of AST was remained significant (P = 0.003); however, the difference for ALT was not remained significant after adjusting potential confounders. Conclusion: The current study based on large sample showed that PA had a statistically negative association with the concentration of liver aminotransferases in the seemingly healthy individuals; however, the observed associations were weak. People in the lowest levels of PA had the highest levels of ALT and AST.

Background: The effect of anticoagulant medication in unexplained early recurrent pregnancy loss (RPL) patients is controversial. This clinical trial evaluated the effect of low-molecular-weight heparin (LMWH) on pregnancy outcomes in these patients. Materials and Methods: The study was performed as a single-blind randomized clinical trial between 2016 and 2018. Samples were selected from patients who were referred to Avicenna RPL clinic with a history of at least two previously happened early unexplained miscarriages. The eligibility was defined strictly to select unexplained RPL patients homogenously. One hundred and seventy-three patients who got pregnant recently were allocated randomly into two groups LMWH plus low-dose aspirin treatment (Group A = 85) and low-dose aspirin treatment only (Group B = 88)) and were followed up till their pregnancy termination (delivery/abortion). A per-protocol analysis was carried out and all statistical tests were two-sided with a P < 0.05 significance level. Results: The live birth rates (LBRs) in Groups A and B were 78% and 77.1%, respectively, which did not show any statistically significant difference between the two groups, neither in rates nor in time of abortion. In subgroup analysis for polycystic ovary syndrome (PCOS) patients, the odds ratio for study outcome (intervention/control) was 2.25 (95% confidence interval: 0.65–7.73). There was no major adverse event whereas minor bleeding was observed in 18% of patients in Group A. Conclusion: LMWH does not improve the LBR in unexplained RPL patients, however, it is recommended to evaluate its effect separately in PCOS patients.

Background: Paddy cultivation of rice requires substantial physical strength, perseverance and manual labor. During the manual harvesting of paddy rice in Iran, laborers are exposed to several work-related physical risks. Paddy cultivation has been reported as one of the most important causes of nonfatal occupational injuries and accidents among farmers. With the aim of identifying which parts of the musculoskeletal structure are mostly affected as a result of working on paddy rice fields, the present study aimed to investigate the potential risk factors for musculoskeletal problems in paddy field workers in Mazandaran Province, Iran. Materials and Methods: A cross-sectional, analytical study was conducted among paddy field workers via multistage sampling in 2019. Prior to the interviews based on the Nordic Musculoskeletal Questionnaire, the participants were briefed about the objectives of the research and their consent was obtained for voluntary participation. Through interviews, data were collected on demographics, agricultural utilization systems, use of paddy tractors, frequency of tiller and tractor use, injuries sustained during the daytime, and outcomes of injuries by paddy field working. Responses were obtained from 384 workers using structured interviews. The respondents were asked to describe problems and pain in their neck, shoulders, elbows, wrists and hands, upper back, hip and lower back. Logistic regression models were used to identify potential risk factors for musculoskeletal problems in specific body regions. Results: The most commonly reported ailments were back pain (n = 29; 7.6%), cardiovascular disease (n = 25, 6.5%) and hypertension (n = 22, 5.7%). The results of logistic regression analysis indicated that the odds of back and shoulder injuries was higher among workers who used tillers and combine harvesters (2.85 and 1.66), transplanting machine (3.68), and those who did not use safe footwear (7). Knee injury risk was higher among those who cultivated rice manually (odds ratio [OR] = 1.35) and who used safety footwear (OR = 1.93), but was lower among those who used tractors (OR = 0.53). There was a small increase in the risk of knee injury with age (OR = 1.03). Confirming earlier works, musculoskeletal problems were found to be highly prevalent among rice workers. Conclusion: Disorders in certain body regions could be explained by specific individual and work-related factors. While the prevalence of work-related injury was high, mostly due to ignorance and disregard for personal convenience of the workers, the findings call for improvements in mechanization and division of labor time and force. Another highlight is that social worth is not given sufficiently to the health of paddy field workers. These should be worked on in future research to find ways of allocating machinery and worth to the workers.

Background: A large liver size is a factor that may increase the difficulty of bariatric surgery (BS) and unwanted complications. Some agents have been used to decrease the liver size before BS. Silymarin has been used as an antioxidant agent to improve liver function tests. This study was designed to evaluate the effects of silymarin on liver dimensions, function, and lipid profile. Materials and Methods: A double-blind randomized clinical trial was performed on 56 patients. The patients were divided into silymarin and placebo groups. Blood samples and sonographic examinations were taken from the patients before and 4 weeks after the administration of the silymarin or placebo. In the first group, 140 mg silymarin was prescribed every 8 h for 4 weeks, and the other group received placebo in the same way with the same tablet shape. After the completion of the 4-week treatment, laboratory tests and ultrasonography were carried out again. Results: Thirty-nine (69.6%) patients were female with a mean body mass index (BMI) of 46.2 kg/m² and a mean age of 36.8 years. Most of the patients had a compliance of 80% and higher. The analysis did not show any significant difference in aspartate transaminase, alkaline transaminase, liver size, cholesterol, and triglyceride changes among the silymarin and placebo groups. BMI loss was slightly higher in the silymarin group although the difference was not statistically significant. Conclusion: The present findings show that silymarin administration for 4 weeks does not affect liver size and function, but further evaluations should be carried out on the subject.