Neonatal sepsis is a leading cause of death in neonates worldwide. The investigation of biomarkers for the early diagnosis of neonatal sepsis is in progress with controversial outcomes. The current ...report aims to evaluate the values of salivary C-reactive protein (CRP) and interleukin-18 (IL-18) for the diagnosis of neonatal sepsis.
In this cross-sectional study, 89 neonates, including 49 neonatal septic case and 40 healthy group admitted at the neonatal intensive care unit, were evaluated. The salivary samples of IL-18 and CRP were measured before the antibiotic therapy initiation, as soon as blood samplings. Sepsis diagnosis was confirmed by the positive blood culture. The diagnostic values of the biomarkers were determined using the receiver operating characteristic curve (ROC curve) analysis. Besides, the sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) positive likelihood ratio (LR+), negative likelihood ratio (LR-), and diagnostic accuracy were measured.
Salivary CRP level was remarkably higher in septic case than healthy group (5.2 ± 4.61 vs. 3.5 ± 1.7;
= 0.02), while salivary IL-18 was not different between the groups (0.1 ± 0.29 vs. 0.04 ± 0.19;
= 0.25). The ROC curve for IL-18 showed insignificant values (
= 0.37). The ROC curve of salivary CRP showed area under the curve of 0.63 (95% confidence interval: 0.51-0.74;
= 0.03) with the sensitivity, specificity, PPV, NPV, LR+, LR - and diagnostic accuracy of 44.9% (31.8-58.7), 80% (65.2-89.5), 73.3% (55.5-85.82), 54.2% (41.6-66.3), 60.6% (50.29-70.18), 2.24 (1.57-3.2), and 0.68 (0.63-0.75) at the cutoff of 4.55 ng/L, respectively.
Based on the findings of the current study, salivary CRP can be considered a biomarker for the early diagnosis of neonatal sepsis, while no statistical values for salivary IL-18 were detected. Due to the significance of neonatal sepsis, further evaluations are strongly recommended.
Burnout is a syndrome of emotional exhaustion, depersonalization, and low professional efficacy that health workers, especially nurses, experience the highest rates of this. Burnout causes stress and ...negative attitude towards work and feeling unable to perform tasks in the person. The purpose of this study was to investigate the effect of a method called compassion, awareness, resilience, and empowerment (CARE) on nurses' burnout.
This study was a semi-experimental study with control group, the statistical population in this study was nurses of Kashani Hospital in Isfahan as intervention group and nurses of Al-Zahra Hospital as control group. The samples were selected by stratified sampling. For both groups before and after and 3 months after the intervention, the burnout questionnaire (Maslach Burnout Inventory) was completed. The intervention was performed in 5 sessions of 90 min 1 day a week. Data were analyzed by SPSS version 25 software (IBM Inc., USA) and independent
-test, repeated measures analysis of variance and Chi-square test and Friedman test, significance level was set at
< 0.05.
The comparison of mean and intensity of burnout and two dimensions of emotional exhaustion and depersonalization showed a difference between the two groups and this difference was statistically significant (
< 0.05). Mean of Individual performance also had a statistically significant difference between the two groups (
< 0.05), but its intensity did not change.
CARE method can be effective in burnout of nurses and it can be used as a practical method. This training program can be implemented both preservice and in-service for health workers.
Epidemiological features of COVID-19 in Iran Tavakolifard, Negah; Moeini, Mina; Haddadpoor, Asefeh ...
Journal of research in medical sciences,
01/2022, Volume:
27, Issue:
1
Journal Article
Peer reviewed
Open access
BackgroundThe first confirmed case of COVID-19 in Iran was reported in February 2019. The current study aimed to investigate the epidemiological aspects of COVID-19 disease in Isfahan province and ...evaluate the chances of infection and death in the population. Materials and MethodsIn this cross-sectional study, 21,203 confirmed cases of COVID-19, based on the polymerase chain reaction test, referred to outpatient facilities from February 2019 to July 2020 in Isfahan province are studied. Disease incidence, mortality, and case fatality rate, as well as odds ratio (OR) of infection and death, were calculated and analyzed using SPSS version 20. ResultsThe highest incidence of the disease was within the age group of 30-39 years 4911 (23.9%) and males 11,561 (54.5%). Mortality in people over 80 years (207 32.9%), men (370 cases 58.7%), diabetics (182 cases 28.9%), and people with cardiovascular disease (165 people 26.2%) was more. In multivariate analysis, patients with a cancer diagnosis had the highest OR of death (OR = 4.03 confidence interval CI: 2.56-6.35) (P < 0.001), followed by those with immune deficiency disease (OR = 2.46 CI: 1.07-5.63) (P = 0.03). As the number of comorbidities increased, the risk of death increased in the total population, so that in patients with more than 4 underlying diseases, compared to the group without disease, the chance of death increased 6.33 times. ConclusionThis study showed that people with cancer and chronic respiratory disease had a higher chance of COVID-19 infection. People over the age of 60, people with cancer, and immunodeficiency also had a higher chance of COVID-19 mortalityW.
Since December 2019, countries experienced different numbers of COVID-19 pandemic waves. The COVID-19 pandemic led to adverse psychologic problems in the communities and among healthcare workers ...(HCWs), but the dynamic of these problems through different waves needs to be established more.
This cross-sectional study was conducted in October 2020, through the third wave of the COVID-19 pandemic, in Isfahan, Iran. We studied HCWs' depression, anxiety, and stress using Depression, Anxiety, Stress Scale-21 (DASS-21) and insomnia using Insomnia Severity Index (ISI) questionnaires. Multiple linear regression was used to evaluate the association of some characteristic factors with different psychologic symptoms.
Our results showed that about 80% of HCWs had one or more psychological problems. The prevalence of depression, anxiety, stress, and insomnia was 46.0%, 50.2%, 44.6%, and 66.5%, respectively. Female sex, working in ICU, and having a history of chronic disease were predictors of psychological symptoms in our participants.
HCWs' mental health state could be underestimated or neglected. The third pandemic wave negatively affected the mental health of the HCWs. Since mental health problems of HCWs may reduce the quality of care, the potential impact of not addressing this issue should be highlighted.
Sexual dysfunction caused by opioids is one of the serious problems of drug misusers.
This study aimed to evaluate and compare the effect of continuous low-dose sildenafil treatment alongside ...psychological training on the sexual function of methadone-treated patients.
This randomized clinical trial was conducted on methadone-treated men with sexual dysfunction. Patients were randomly divided into two treatment groups: sildenafil 25 mg and psychological training. Sexual Quality of Life-Men, Sexual Self-Efficacy Scale-Erectile, and the International Index of Erectile Function were used before and 4 weeks after the end of the intervention.
A total of 67 couples were included in the study (34 psychological interventions vs. 33 sildenafil group). After 4 weeks of treatment, the mean of male erectile function (33.73 ± 8.114 and 27.62 ± 6.238, p = 0.003) and sexual self-efficacy score (78.36 ± 12.713 and 69.62 ± 14.940, p < 0.0001) in the sildenafil group were statistically significant compared to the psychological group, however, the sexual quality score of the two groups was not statistically significant (31.48 ± 9.216 and 31.71 ± 11.333, p = 0.342).
The sexual function of methadone-treated men in both groups was significantly improved, yet this difference was significantly greater in the pharmaceutical treatment group than the trainings. As a result, due to the high need for treatment, any type of intervention (medication or psychotherapy) will be effective in these patients.
Background: COVID-19 pandemic placed immense pressure on health systems. The current study aimed to evaluate the symptoms of COVID-19 in Isfahan province and their association with disease outcome. ...Materials and Methods: In this cross-sectional study, which was conducted on patients with a definite diagnosis of COVID-19, as a part of the investigations performed by the Deputy for Public Health of the Isfahan University of Medical Sciences, the frequency of underlying diseases, and general, respiratory, gastrointestinal, neurological, renal, cardiac, dermal, hearing symptoms are assessed using a checklist. The participants were followed up 1 month after definitive diagnosis, and the outcome of the disease (recovery or death) was recorded. Results: Of 300 patients, 143 (47.4%) were male and 157 (52.6%) were female. The mean age of patients was 43 ± 17.84 years. Muscle pain and fatigue were the most common early symptoms (63% and 60.3%, respectively). Age, sex, level of education, and occupation of patients and general, respiratory, and gastrointestinal symptoms and underlying diseases of respiratory disease showed a statistically significant association with the disease outcome (P < 0.05). Conclusion: General, respiratory, and gastrointestinal symptoms were associated with an increased risk of death due to COVID-19. General, visual, and hearing symptoms, and diabetes, cardiovascular diseases, and respiratory disease had a statistically significant association with the hospitalization of patients.
High systolic blood pressure is the leading risk factor for global mortality. Applying effective strategies to control hypertension is a rising concern. Guidelines are approved to be effective in the ...management of patients with cost-effective interventions. The aim of this study is to evaluate the adherence of family physicians working in Isfahan health centers to the national hypertension guideline, in 2019.
Using a cross-sectional study, the practice of 43 physicians selected by a multistage sampling method from the perspective of hypertension management was observed in 377 visits. The data gathering form was designed according to the national hypertension guideline. Adherence to the guideline was evaluated by dividing the earned score by the most score one can earn. Data were analyzed using Independent
-test, Pearson correlation and linear regression model.
The mean score of adherence to the national hypertension guideline was 33.6 ± 16.42%. There was a significant association between physician's sex, years passed from graduation, type of occupation contract, type of university of education, and attending empowerment class and adherence to the national hypertension guideline.
The results of our study show that family physicians just follow one-third of the recommendations in the national hypertension guideline.
This article introduces the updated version of the Iranian guideline for the diagnosis and treatment of hypertension in adults. The initial version of the national guideline was developed in 2011 and ...updated in 2014. Among the reasons necessitating the update of this guideline were the passage of time, the incompleteness of the scopes, the limitation of the target group, and more important is the request of the ministry of health in Iran.
The members of the guideline updating group, after reviewing the original version and the new evidence, prepared 10 clinical questions regarding hypertension, and based on the evidence found from the latest scientific documents, provided recommendations or suggestions to answer these questions.
According to the updated guideline, the threshold for office prehypertension diagnosis should be considered the systolic blood pressure (SBP) of 130-139 mmHg and/or the diastolic blood pressure (DBP) of 80-89 mmHg, and in adults under 75 years of age without comorbidities, the threshold for office hypertension diagnosis should be SBP ≥ 140 mmHg and or DBP ≥ 90 mmHg. The goal of treatment in adults who lack comorbidities and risk factors is SBP < 140 mmHg and DBP < 90 mmHg. The first-line treatment recommended in people with prehypertension is lifestyle modification, while for those with hypertension, pharmacotherapy along with lifestyle modification. The threshold to start drug therapy is determined at SBP ≥ 140 mmHg and or DBP ≥ 90 mmHg, and the first-line treatment is considered a drug or a combined pill of antihypertensive drugs, including ACEIs, ARBs, thiazide and thiazide-like agents, or CCBs. At the beginning of the pharmacotherapy, the Guideline Updating Group members suggested studying serum electrolytes, creatinine, lipid profile, fasting sugar, urinalysis, and an electrocardiogram. Regarding the visit intervals, monthly visits are suggested at the beginning of the treatment or in case of any change in the type or dosage of the drug until achieving the treatment goal, followed by every 3-to-6-month visits. Moreover, to reduce further complications, it was suggested that healthcare unit employees use telehealth strategies.
In this guideline, specific recommendations and suggestions have been presented for adults and subgroups like older people or those with cardiovascular disease, diabetes mellitus, chronic kidney disease, and COVID-19.
Macular amyloidosis (MA) is one of the most common types of primary localized cutaneous amyloidosis (PLCA), distributed predominantly over the trunk and extremities. Due to the vast therapeutic ...options, this study aims to compare the effectiveness of Q-switched Nd: YAG laser 1064 nm and Er: YAG laser 2940 nm in treating MA. This clinical trial was performed in 2020–2021 on 33 women with MA. In each patient, the lesion was randomly divided into two areas, A and B. Area A underwent four treatment sessions with 4-week intervals of Q-switched Nd: YAG laser 1064 nm. Area B underwent four treatment sessions with an Er: YAG laser 2940 nm at 4-week intervals. Degree of basal pigmentation and degree of pigmentation after treatment, pruritus intensity, before and after the treatment, and patient and physicians’ satisfaction were measured and compared. The pruritus in patients improved significantly after the study (
P
< 0.001), but no significant differences could be observed between the two groups regarding the improvements (
P
> 0.05). We also found no significant differences between the two groups of patients regarding patient and physicians’ satisfaction rates (
P
> 0.05). The use of both Q-switched Nd: YAG laser and Er: YAG laser resulted in improvements in terms of pruritus, patient and physicians’ satisfaction, and total improvement in pigmentation of the lesions.
BackgroundThe aim of this study was to compare the effect of adding oral clonidine to standard treatments on pain intensity in patients with acute renal colic. Materials and MethodsThis is a ...randomized clinical trial that was performed in 2020 in Isfahan. The study population consisted of 200 patients with renal colic. Pain of the patients was assessed using Visual Analog Scale. Patients were then randomized into 4 groups of 50 patients. Group A received 0.1 mg/kg morphine and clonidine tablets (0.2 mg). Group B received morphine and placebo. Group C received 30 mg ketorolac and clonidine tablets. Group D received 30 mg ketorolac and placebo tablets. Pain of patients was assessed. 0.05 mg/kg morphine was administered and repeated every 40 min if the pain was not reduced. ResultsOur data showed that there was a significant difference between pains of patient by the time of admission in groups (P = 0.04). However, no significant differences were observed between pains of patients in different measuring times (P > 0.05). Using general linear model, we showed that the decreases in pain scores of each group were significant (P < 0.05) but there were no significant differences in pains of patients in different measuring times (P > 0.05). Our data showed that Group A and Group C had lowest frequencies of morphine administrations while Groups B and D had the highest frequencies (P < 0.001). ConclusionWe showed that administration of clonidine in patients with renal colic resulted in better pain control and lower morphine injections.
PDF
