How the first cases of COVID-19 in 10 countries become infected? a case series

Recently, a new respiratory infectious disease called COVID-19 has emerged and created a global emergency. It was initially linked to the animal-to-human transmission. However, it is now thought that COVID-19 is spreading through human-to-human transmission mainly via droplets. As there is no definite antiviral therapy for the treatment of cases with COVID-19 the best option for slowing down the pandemic and reducing mortality rates is protection against the virus of interest. To achieve this goal obtaining information about how first cases infected with COVID-19 is crucial. Hence, this study aims to review the studies published in peer-reviewed journals to report the first confirmed cases with COVID-19. Herein, we review the origin, symptoms, diagnostic tests, and progress of the disease and possible actions of authorities which would be effective in similar pandemics in the future. This study reviewed 13 cases (5 females and 8 males; 25-61 years old) from 10 countries. All cases have recovered from COVID-19. The results of this review suggested that timely reports of the confirmed cases, notifying World Health Organization and providing information to the general population about the methods of spreading the virus would have decreased the number of infected cases and mortality rates. In addition, the travel history of the first confirmed cases in various countries suggested that prompt actions in restricting travels and closing borders could be an efficient strategy in preventing the transmission of the disease outside of the affected sites. Efforts should be taken by health authorities for preparing the world for future epidemic/pandemic in terms of developing advanced screening strategies in the borders and diagnostic strategies for early identification of infected cases.

Effects of transcranial direct current stimulation on gait in people with Parkinson's disease: study protocol for a randomized, controlled clinical trial

BACKGROUND

Gait difficulties are common and frequently devastating to people with Parkinson's disease (PD). These difficulties are often followed by an increased risk of falls, leading to injury, hospitalization and mortality. The dysfunction in the basal ganglia-thalamocortical motor circuits and reduced activity in the premotor and primary motor cortices has raised interest in transcranial direct current stimulation (tDCS) as an adjunct intervention in PD. tDCS might provide a potentially safe and non-invasive treatment by modulating cortical excitability and behavioural outcomes. The aim of this study is to compare the effects of different monopolar and bipolar montages of tDCS administered to the motor cortex and cerebellum on gait speed in PD.

METHODS

This study will be conducted in a randomized, double-blind cross-over design. Eighteen participants diagnosed with Parkinson's disease will receive anodal and sham tDCS (1 mA, 20 min, 10 × 4 cm²) over the premotor and primary motor cortices with the cathode over the cerebellum during treadmill walking. Three montages will be applied over three sessions and compared: anodal tDCS with a small active cathode (4 × 4 cm²); anodal tDCS with a large, functionally inert cathode (10 × 10 cm²); and sham tDCS. The primary outcome measure is gait speed, and secondary outcome measures include gait parameters (temporospatial, segmental, kinematic), the Timed Up and Go test and lower limb muscle activity patterns as measured by electromyography.

DISCUSSION

This study will investigate the short-term effects of anodal tDCS over the premotor and primary motor cortices on gait abilities using monopolar and bipolar montages in people with PD. The outcomes will inform future studies aimed at inducing longer-lasting changes in neural excitability and performance using multisession tDCS designs in PD.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12618000063213 . Registered on 17 January 2018. Retrospectively registered.

Predicting risk of the fall among aged adult residents of a nursing home

BACKGROUND

Fall is one of the most important outcomes of geriatric medicine. The European Assessment System (EASY) Care Standard provides a tool for assessing the risk of the falls. We aimed to evaluate the validity of the Easy-Care risk of the falls (ECRF) sub-score among the residents of a large nursing home.

METHOD

A longitudinal study was conducted within a maximum of 34 months following up for falling in Kahrizak Charity Foundation. At the baseline the demographic, mental status and the depression data of 194 subjects aged ≥60 was collected. The Easy-Care standard tools and Performance-Oriented Mobility Assessment (POMA) were also used for data collecting. The time, location, and cause of the falls were recorded immediately after each fall incident. The Correlation between POMA and ECRF scores and the factor analysis of ECRF were considered as the concurrent and construct validity respectively. The Factor affecting the fall occurrence was assessed using the Cox-regression model.

RESULT

The mean age of the participants was 76.02 (SD 8.82). Fifty two individuals (27.3%) fell at least once during the mean 756 (SD 187)-day follow up. The Spearman correlation coefficient between ECRF and POMA scores was -0.458 (P<0.01). Three components were detected in the factor analysis of the ECRF. In the univariate Cox-regression model, the hazard ratio was 1.04 (CI: 1.00-1.07) for each score increase of the ECRF. For the six-month follow-up, at the ECRF cut-off point two of eight, the sensitivity and specificity were calculated as 85.7% and 64.5% respectively.

CONCLUSION

It seems that the ECRF is a valid tool for predicting the next 6 months' fall incidents in older adults.

Depression in mothers of children with cerebral palsy and its relation to severity and type of cerebral palsy

Children with cerebral palsy (CP) suffer from several problems, so the family especially the mothers undertake a lot of social and emotional difficulties. The purpose of this study was to determine the severity of depression in mothers of children with CP in comparison with mothers who have normal children and its relation to the type of CP and severity of the disability. During this descriptive-analytic study, 43 mothers who had younger than 8 year-old children with CP under rehabilitation services in SABA clinic, related to the University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran, were selected as the case group by simple sampling. A data registration form and the Beck Depression Inventory II were completed by them. The type of CP and the severity of disability were determined by a pediatrician and an occupational therapist respectively, using the Gross Motor Function Classification System (GMFCS). Seventy-seven mothers of normal children, serving as the control group for comparing with case group, filled in the same questionnaires. There were significant differences in the mean depression scores (P=0.003) between the two groups. Having a child with CP also increases the risk of developing depression in mothers as much as 2.26 times (OR=2.26). There were no statistically significant differences in depression scores and the severity of disability and also among the five types of CP. It seems that having a child with CP is probably associated with higher prevalence and severity of depression in mothers. So treatment or prevention of depression in mothers of children with CP is highly recommended for improving the rehabilitation process and achieve better results in these children.