فهرست مطالب bagher pahlavanzade

COVID-19 is a new disease and there is limited information about the risk factors. This study aimed to determine epidemiologic and clinical characteristics of hospitalized COVID-19 patients in Abadan.Subjects and

In this case-control study, the patients who died from COVID-19 were selected as the cases and those hospitalized in Taleghani Hospital with a definite diagnosis of COVID-19 who were finally discharged from the hospital with a favorable general condition, were considered as control group. Data were extracted from patient records. Logistic regression and Generalized Estimating Equation(GEE) analyses were used to determine the risk factors for death from COVID-19. The analysis was performed using SPSS software version 27 at the significance level of 0.05.

Demographic, clinical and laboratory data of 221 discharged individuals and 221 deaths were assessed. 47.5% of control and 40.89% of cases were female. Cases had higher mean age, higher rate of underlying disease, and low oxygen saturation compared to controls, but the incidence of diarrhea was higher in the control group than the case group.

Although the diarrhea are associated with reduced mortality in the studied patients, it is necessary to consider other unexamined hidden factors for correct judgment.

Since medical care providers are faced with complex issues in their profession, one of the important skills in making correct clinical decisions is critical thinking. Therefore, one of the standards of medical education is to instill critical thinking in students.

The present study was a cross-sectional descriptive-analytical study. Data was collected using a demographic questionnaire and the standard California B questionnaire. Mann-Whitney test was used to make comparisons, and Spearman's correlation coefficient was used to check the correlation between the data.

The findings showed that the average critical thinking score of the participating medical students was 8.05 (± 2.6). Also, analysis and inference had the highest 2.5 (± 1.58) and lowest 2.51 (± 1.04) levels of obtainable score, respectively. Critical thinking had a significant positive correlation with all its components (P<0.001). The critical thinking of the participants was not significantly different in terms of gender or university entrance examination regions (P>0.05). The analysis showed that critical thinking has a significant positive correlation with age (r=0.159, P=0.018) but a significant negative correlation with years of education (r=-0.216, P=0.001) and grade point average in the last semester (r=-0.492, P=0.012).

The studied medical students did not have an optimal level of critical thinking, which is necessary for making appropriate and effective decisions, and this skill was found to have an inverse relationship with the grade point average and academic years. Therefore, it can be argued that the current educational system in the university has not been able to enhance this vital skill among medical students.

Gestational diabetes (GDM) is one of the most important causes of complications during pregnancy and has a high prevalence, so it is essential to identify the factors affecting its physiopathology as a way to prevent and treat it. Therefore, the present study was performed with aim to investigate the serum level of vitamin D in healthy and diabetic pregnant women.

This case-control study was conducted in 2022-2023 on 198 pregnant women (99 with gestational diabetes and 99 without gestational diabetes in the control group) referred to the treatment centers of Abadan University of Medical Sciences. After obtaining consent from the subjects and recording demographic information, serum vitamin D levels were also recorded. Data were analyzed by SPSS software (version 24) and Independent T and Pearson correlation tests. P<0.05 was considered statistically significant.

The mean serum level of vitamin D in women with GDM was significantly lower than pregnant women in the control group (16.97 vs. 26.76 ng/ml). By grouping pregnant women based on age, gestational age, gravid and BMI, women with GDM had lower mean vitamin D levels than pregnant women in the control group (P<0.05). In the correlation analysis of women with GDM, vitamin D level had an inverse and significant relationship with 1-hour sugar (r=-0.212 and P=0.035) and 2-hour sugar (r=-0.223 and P=0.026), but no significant relationship with FBS level was observed. The sensitivity and specificity of vitamin D in the diagnosis of GDM at the cut-off point of 18.05 were 69.7% and 74.7%, and the positive and negative predictive value were 73.4% and 71.2%, and the overall accuracy was 72.2% and the level of agreement was moderate.

Women with GDM had significantly less vitamin D, which can be considered a risk factor for GDM during pregnancy.

 Vitamin C is a micronutrient with anti-inflammatory and free radical scavenging properties that can strengthen the body’s immune system. In this study, it was attempted to assess the clinical efficiency of oral vitamin C in treating COVID-19.

 This double-blind randomized clinical trial was conducted on 401 patients hospitalized in Taleghani hospital, Abadan, over 18 years of age and with confirmed COVID-19 infection, from November 2020 to May 2021. The patients were randomly assigned to intervention groups (201 people, two tablets per day, each containing 500 mg of vitamin C) and the control group (200 people, placebo, containing starch received for five days). Improvements in clinical symptoms, death from baseline to the 28-day follow-up after the intervention, hospital length of stay, and laboratory values of C-reactive protein (CRP) were some of the considered outcome variables.

 No significant difference was observed between the two groups in terms of the daily improvement of clinical symptoms and the odds of healing from each symptom increased by about 48-50%. The difference in the length of hospital stay between the two groups was close to significant (P=0.051). There was no significant difference in mortality between the two groups (P=0.8). There was no difference between the two groups in the laboratory parameters, except for alkaline phosphatase (P=0.03).

 Vitamin C had no significant effect on improving patients’ clinical symptoms such as fatigue, fever, cough, and shortness of breath.

Despite advances in prenatal care, there is a high rate of morbidity and mortality in infants of diabetic mothers. Interventricular septal hypertrophy is a well-known congenital heart abnormality in neonates of mothers with gestational diabetes. In this study, we investigate the effect of gestational diabetes mellitus on interventricular septum thickness.

In this cross-sectional cohort study, 42 neonates from mothers with gestational diabetes mellitus and 42 neonates from non-diabetic mothers were selected from gynecology ward of Sayyad Shirazi Hospital in Gorgan (Iran) between April 2016 and April 2017. Ventricular septum thickness in neonates was measured by M-mode echocardiography. Comparison of septum thickness and frequency of septal hypertrophy between the two groups was performed using t-test, Mann-Whitney test and chi-square test. All statistical analyses were preformed in SPSS 16 at significance level of 0.05.

The mean septum thickness was 4.51±1.58 mm in newborns of non-diabetic mothers and 5.84±1.44 mm in newborns of diabetic mothers (P<0.001). Septal hypertrophy (thickness of ≥6 mm) was significantly more common in newborns of diabetic mothers (P=0.029). In addition, we found no significant difference in septum thickness between newborns of diabetic mothers receiving diet or insulin therapy.

Overall, our findings suggest that there is a significant correlation between gestational diabetes and ventricular septal hypertrophy. In addition, glycemic control with diet or insulin therapy has no significant impact on septum thickness.

Analyzing the health risk associated with the microbial contamination of seawater is necessary to ensure that there is not any threat to human or environment. The aim of this study was to evaluate the microbiological quality of Caspian sea water using indicator bacteria. Some Physicochemical parameters were studied to assed their association with the contamination level of Caspian sea water due to the important role in the growth organisms in the seawater.

In this study, 100 samples were collected from the northeastern zone of the Caspian sea, Iran, from November 2017 to December 2018. Total coliform, Fecal coliform, E.coli, Fecal Streptococcus and Clostridium perfringens were the indicator bacteria and temperature, pH, electrical conductivity, chloride and turbidity were water physicochemical factors according to standard methods.

The finding showed that the mean of Total coliform, Fecal coliform, E.coli, Fecal Streptococcus, and Clostridium perfringens were 614.72 ± 516.13, 62.11 ± 235.30, 49.69 ± 188.24, 348.02 ± 490.01 and 3.04 ± 5.76 MPN/100 ml, respectively. Furthermore, the mean and SD of temperature, pH, electrical conductivity, chloride, and turbidity were 13.84 oC ± 5.62, 8.27 ± 0.45, 17.96 ± 6.56 µs/cm, 5776.95 ± 1996.38 mg/l and 27.48 ± 15.82 NTU, respectively. Statistical analysis showed that microbial qualities were affected significantly by physicochemical factors, but the roles of water temperature were more than others.

The microbiological results revealed that there was a remarkable level of contamination in some areas of Caspian sea. The results suggested that Clostridium perfringens provide better health risk prediction than other analyzed indicator bacteria, particularly in the warm season.

Lipid abnormalities are major risk factors of death from cardiovascular disease (CVD). As well as, lipid markers are time-dependent covariates that change with aging. Previous cohort studies have only investigated baseline measurements of lipid markers on CVD mortality.

The study sample consisted of 4,148 individuals aged over 40 years. Total cholesterol (TC), LDL-cholesterol (LDL-C), and HDL-cholesterol (HDL-C) were measured in five phases. A joint model analysis was used to investigate the association between each longitudinal lipid markers and CVD mortality in men, women and pooled sample. All analysis was performed using the survival and joint modeling packages in R 3.3.3.

Totally, 233 CVD deaths occurred during a median follow-up of 12.4 years. For men, CVD mortality increased by 28% (confidence interval [CI]: 14%,44%) for a 10% increased in TC. For women, CVD mortality increased by 43% (CI: 22%, 68%) and 21% (CI:7%, 37%) for 10 % increase in TC and LDL-C and decreased by 18% (CI:7%, 27%) for a 10% increase in HDL-C.

Association of lipid ‎markers with CVD mortality is different in men and women, such that high levels of TC ‎and ‎LDL-C and low levels of HDL-C are risk factors of CVD mortality in women, but only TC is a risk ‎factor of CVD mortality in men.

It has been proposed that lipid markers may predict cardiovascular events; however, their effect may vary depending on the type of cardiovascular disease. The purpose of this study was to investigate the effects of lipid markers on death from coronary heart disease (CHD) and stroke in competing risks setting. Participants included 2502 women and 2020 men, age 40 years or older from Tehran Lipid and Glucose Study. The association between total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) with hazard and cumulative incidence of CHD and stroke was investigated using cause-specific hazard and sub-distribution hazard models. Statistical analyses were performed using “risk regression” and “cmprsk” package in R 3.3.2. One standard deviation (SD) increase in TC and LDL-C increased the hazard of CHD death by 1.42 (CI=1.07,1.89) and 1.41 (CI=1.04,1.93), respectively. 1-SD increase in TG increased the cumulative incidence of CHD death increased by 1.94 (CI=1.02,3.75) in women. Other risk factors were not associated with the hazard and cumulative incidence of CHD in women, men and the total sample. In addition, none of lipids had a significant effect on the hazard and cumulative incidence of stroke in men, women and the total sample. The associations of lipid components on CHD death were modified by gender. TC, LDL-C and TG were independent predictors of CHD mortality in women. Furthermore, death due to stroke changes the association of lipid markers with CHD mortality.

The transtheoretical model (TTM) is used as a framework to implement smoking cessation programs. This model has some subscales based on which the smoking temptation scale is proposed as stages movement factor. This study aimed to translate and validate the temptation subscales of the TTM questionnaire in the Iranian population. This cross-sectional study was conducted on 387 smokers. The participants were selected using convenience sampling method. First, the smoking temptation scale designed by Velicer et al. was translated into Persian, and then, factorial validity of the hierarchical three-factor structure for this subscale was studied using factor analysis and measurement invariance (MI) methods. All analyses were performed using Mplus software. It was observed that the hierarchical three-factor structure model had a good fit to the data [confirmatory fit index (CFI) = 0.944, Tucker-Lewis index (TLI) = 0.915, Root Mean Square Error of Approximation (RMSEA) = 0.067, standardized root mean square residual (SRMR) = 0.042]. This study showed that this factorial structure had an identical measurement and structural model in subgroups of the population such as rural and urban residence, highly educated and low educated, high income and low income, three stages of quitting, and across the three ethnicities. Given the validity and reliability of the hierarchical three-factor structure for smokingtemptation scale, this measure can be used in interventional programs for smoking cessation in the Iranian male population.

In survival studies, incidence of competing risks causes that the time of event of interest to be unknown. Analysis of competing risk data, often implemented using hazard-based method under proportional hazard assumption. In this study, we interpreted covariate effect under accelerated failure time model and cause-specific survival function. Methods & Materials: We considered weibull hazard and survival function as cause-specific hazard and survival function and explored the relation between these function. Estimation of parameters performed using Bayesian methods with non-informative priors that implemented in R2WinBUGS package of R software. Simulation study showed that, the relation between hazard and survival parameters for weibull distribution is also established between parameters of cause-specific hazard and cause-specific survival function. This relation also verified in PBC data set for logarithm of serum bilirubin and D-penicillamine effect. Although in competing risk studies, most of the analysis performed under PH assumption, analysis based on AFT models will also be applicable for these data. In these setting, coefficients can be interpreted as effects of covariate on time to each event.

Since adolescent's intellectual growth is not perfect, they are not able to control their behaviour the same as adults and they might show rapid and intense reactions like aggression. Given to the harmful impact of aggression on their social development, the current study aimed to determine the prevalence of aggression and associated factors in adolescents in Gonbad-e-kavous.
in this cross-sectional study, 570 students were selected through cluster random sampling in 2013-2014 academic years. The data was collected by Buss and Perry aggression questionnaire and analysed through linear regression (p≤0.01) using SPSS 18.
Findings: The students were 15.99±0.89 with a range of 14-18 years. The prevalence of aggression was 42.4% (43.7% in females and 41% in males). There was a significant correlation between ethnicity and their aggressive behaviour in that it was the lowest among Turkmen participants (p Given the high prevalence of aggression in high schools students, decreasing of computer games and recognizing of cultural and ethnic factors can be effective in controlling of aggression.

Inability to measure exact exposure in epidemiological studies is a common in many epidemiological studies, especially when information on exposure is obtained retrospectively, as in any case–control design. Depending on the extent of misclassification, results may be affected. Existing methods for solving this problem require a lot of time and money and for and for some of exposures it is not practical. Recently, new methods have been proposed in 1:1 matched case–control study that have been solved these problems to some extent. This paper extend existing Bayesian method to adjust for misclassification in matched case–control Studies with 1:2 matching. The standard Dirichlet prior distribution for a multinomial model is extended to allow separation of prior assertions about the exposure–disease association from assertions about other parameters. Information that exist in literature about association between exposure and disease used as prior information about OR. Correction of misclassification was investigated using Sensitivity analysis. The results of naïve Bayesian model were similar to the classic model. The second Bayesian model that use prior information about the OR, heavily affected by this information. The third model provides maximum bias adjustment for heavy metals, tobacco and opium. This model showed that heavy metal is not an important risk factor although raw model (logistic regression Classic) detected this exposure as an influencing factor on the incidence of lung cancer. Sensitivity analysis showed that third model is robust regarding to different levels of Sensitivity and Specificity. Result of this study showed that although in most of exposures the results of the second and third model were similar but the proposed model able to somewhat correct the misclassification.