bahman cheraghian

Tuberculosis (TB) and infection of Hepatitis C virus (HCV) have appeared as major public health problems. The present systematic review and meta-analysis aimed at determining the relationship between TB and the risk of HCV infection.

Google Scholar, Embase, Medline, Pubmed, web of sciences (ISI), and Scopus were searched until March 2022. The pooled ORs of HCV in patients with TB were calculated utilizing the random-effect model with a 95% confidence interval (CI). test was utilized for evaluating the heterogeneity. To check publication bias Egger and Beggs' tests were used.

From among 1500 articles from 2006 to 2020, 13 studies were examined and analyzed based on the inclusion/exclusion criteria. The overall risk of HCV infection in patients with TB was (OR: 1.34, 95% CI: 1.10-1.63, P=0.001). According to the type of the countries subgroup analysis, the risk of HCV infection in patients with TB in developing countries was (OR: 1.95, 95% CI: 1.00-3.80), which was higher than the risk in developed countries (OR: 1.47, 95% CI: 1.42-1.52). In addition, the risk of hepatitis C infection in men compared to women (OR: 1.84, 95% CI: 1.75-1.94, P=0.001) and in age groups over 65 yr compared to other age groups (OR: 1.46, 95% CI: 0.98-2.16) was significantly higher.

The results of this study emphasized the importance of screening HCV in patients with TB. Being aware of the presence or absence of HCV in these patients can contribute to their effective treatment.

There is disagreement about the correlation between serum 25-OH vitamin D (25OH-D) concentrations and ovarian reserve. The aim of this study was to evaluate the correlation between serum levels of 25OH-D and ovarian reserve parameters, including Anti-mullerian hormone (AMH), Follicle stimulating hormone (FSH), and Antral follicular count (AFC) in the tropical zone.

In this cross-sectional study, 148 infertile women were enrolled. On the third day of their cycles, vitamin D3, FSH, and AMH were measured. An ultrasound scan was done for the measurement of the ovaries AFC. Participants were divided into women with normal ovarian reserve (NOR) and women with diminished ovarian reserve (DOR). Then two groups were compared based on the levels of vitamin D.

Our findings showed that there were significant differences in vitamin D levels between the DOR and NOR groups (11.52±12.24 and 22.74±12.7, respectively), (P value <0.001). The partial Spearman correlation test depicted an inverse relationship between vitamin D and FSH (rho =-0.21, P =0.009). Also, there was a positive relationship between vitamin D and AMH and AFC, (rho=0.27, P=0.001) and (rho=0.39, P< 0.001) respectively.

This study demonstrated that there was an inverse relationship between levels of vitamin D and FSH and a positive relationship with AMH and AFC. It appears that the level of vitamin D is important in DOR.

Midwives, as members of the health team, have an important role in providing health services at three levels of the care system, especially the health center, family, and community. Self-efficacy of clinical performance is an essential variable in providing quality services. This study was conducted to compare the self-efficacy of clinical performance of midwife and non-midwife healthcare workers, working in Ahvaz health centers.

The present study is a cross-sectional descriptive-analytical study carried out on 115 healthcare workers (67 midwives and 48 non-midwives) working in health centers in Ahvaz, Iran. Participants were selected based on the inclusion and exclusion criteria and completed the self-efficacy clinical performance questionnaire. Finally, the results were analyzed in two groups of midwives and non-midwives’ health care workers.

According to the analysis, midwives had the highest score of clinical self-efficacy in prenatal care, while non-midwives had the highest score in the field of children. Also, in midwives compared to non-midwives, the self-efficacy score of clinical performance in all areas except children was significantly different, and in all areas, the mean score obtained by midwives was higher than that of non-midwives (p <0.001).

Given the higher rate of clinical performance in midwives compared to the non-midwives group, as healthcare providers, in all areas of care provided to healthcare clients, health policymakers should consider this capability of midwives in planning related to health promotion.

Pressure ulcer is a common problem in ICUs and its prevention is one of nurses’ duties.

The present study was performed with aim to evaluate the effectiveness of preventive nursing care based on Braden’s scale on the incidence of pressure ulcer in ICU patients.

This clinical trial study was performed on 72 patients admitted to the ICUs of Golestan and Imam Khomeini hospitals of Ahvaz in 2020. The preventive care based on Braden scale was performed for 6 days in the intervention group. Routine care was provided for the control group. The rate and duration of pressure sores were measured based on Braden scale at the beginning of the study, every 48 for 3 times for the intervention group. The data was collected by demographic information questionnaire, Braden scale, and Pressure Ulcer Scale for Healing (PUSH).

The pressure ulcers occurred less in the intervention group (2.8%) than in the control group (8.3%), but this difference was significant (p=0.614). There was a significant difference between the two groups in terms of Braden's subscales during the intervention period (first, second and third 48 hours) (p<0.05). Preventive care increased the length of time required for the occurrence of pressure ulcers in the test group.

Implications for Practice:

 The results showed that the intervention based on the Braden scale reduces pressure ulcers, therefore it is recommended that nurses carry out care interventions based on the Braden scale to improve the quality of care and prevent pressure ulcers among ICU patients.

Protective behavior is recommended to prevent COVID-19. However, the existing gap is no reliable evidence of protective behavior in southern urban areas in Iran. This study aims to estimate the prevalence of face mask usage and shield use among pedestrians in the Abadan, Khoramshahr, and Shadegan southern cities of Iran. 

This population-based cross-sectional study was conducted from June to August 2021 in the southwestern urban population of Iran. In this study, 7 425 pedestrians were selected from 85 neighborhoods. Sampling was conducted using a multi-stage method. The data were collected by observation passers on the street with a checklist and analyzed by SPSS software, version 26 statistical and WINPEPI software. The acceptable significance level was P<0.05.

A total of 55.4% of the subjects were men. The prevalence of face mask usage was 3990(53.8%) (95% CI, 52.7%-55%). The correct use of the face mask and shield were (38.5% and 0.4%), respectively. The use of a face mask was higher in men than women (54.3 vs 53%). Pedestrians under 10 years (39.2%) and over 70 years (44.7%) had the lowest use of the mask. The use of face mask was more in the evening and night (58.1% vs 54.3%), and a significant relationship was observed between the use of the face mask and age (P<0.05).

 The prevalence of the use of face mask is relatively low. Therefore, the possibility of controlling the infection may be difficult. Promoting media literacy, emphasizing the perceived benefits of preventative behavior, and setting rules may improve mask use.

Tuberculosis is a principal public health issue. Reducing and controlling tuberculosis did not result in the expected success despite implementing effective preventive and therapeutic programs, one of the reasons for which is the delay in definitive diagnosis. Therefore, creating a diagnostic aid system for tuberculosis screening can help in the early diagnosis of this disease. This research aims to use machine learning techniques to identify economic, social, and environmental factors affecting tuberculosis.  

This case-control study included 80 individuals with TB and 172 participants as controls. During January-October 2021, information was collected from thirty-six health centers in Ahvaz, southwest Iran. Five different machine learning approaches were used to identify factors associated with TB, including BMI, sex, age , marital status, education, employment status, size of the family, monthly income, cigarette smoking, hookah smoking, history of chronic illness, history of imprisonment, history of hospital admission, first-class family, second-class family, third-class family, friend, co-worker, neighbor, market, store, hospital, health center, workplace, restaurant, park, mosque, Basij base, Hairdressers and school. The data was analyzed using the  statistical programming R software version 4.1.1.   

According to the calculated evaluation criteria, the accuracy level of 5 SVM, RF, LSSVM, KNN, and NB models is 0.99, 0.72, 0.97,0.99, and 0.95, respectively, and except for RF, the other models had the highest accuracy. Among the 39 investigated variables, 16 factors including First-class family (20.83%), friend (17.01%), health center (41.67%), hospital (24.74%), store (18.49%), market (14.32%), workplace (9.46%), history of hospital admission (51.82%), BMI (43.75%), sex (40.36%), age (22.83%), educational status (60.59%), employment status (43.58%), monthly income (63.80%), addiction (44.10%), history of imprisonment (38.19%) were of the highest importance on tuberculosis.  

The obtained results demonstrated that machine-learning techniques are effective  in identifying economic, social, and environmental factors associated with tuberculosis. Identifying these different factors plays a significant role in preventing and performing appropriate and timely interventions to control this disease.

Recent research shows that most of the patients with multiple sclerosis (MS) have cognitive-like disorders. Due to the beneficial effects of atomoxetine on improving cognition in limited animal and human surveys, the aim of the present study was to investigate the effect of the atomoxetine on improving cognitive disorders of MS. This study was a parallel, randomized clinical trial, designed to investigate the effect of atomoxetine drug on the improvement of cognitive impairment (CI) in MS, from April 2021 to March 2022. According to the inclusion and exclusion criteria, a total of 52 participants were involved in the study and then randomly divided in two groups of 26. Experimental group was treated with atomoxetine and the control group was treated with placebo. The Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) test was performed for assessment at the beginning and after 3 months. The California Verbal Learning Test (CVLT), the CVLT-delay, the Brief Visuospatial Memory Test-Revised (BVMT-R), and the Symbol Digit Modalities Test (SDMT) were used to evaluate the CI and changes following medication. Finally, data were analyzed by SPSS software at significance level of 0.05. The mean age of patients in the experimental group was 37.7 ± 8.5 and in the placebo group was 37.8 ± 7.6 (P = 0.32). The results showed significant changes in cognitive levels before and after the use of atomoxetine and also in comparison to the placebo group (P < 0.05). This study showed that atomoxetine improved the cognitive domains after administration compared to placebo.

Background and Objectives Acute gastroenteritis is among the leading causes of mortality in developing countries. The present study aimed to compare zinc levels in children with and without acute gastroenteritis. Subjects and Methods This case-control study was conducted on children with acute gastroenteritis and age and gender-matched control group without gastroenteritis. A total of 80 children with acute gastroenteritis and 80 children without gastroenteritis were included. The control group was selected from among patients admitted to the pediatric surgery ward for a minor surgery. The case and control groups were matched regarding age and gender. The inclusion criteria for the control group were as follows: onset of diarrhea less than 48 hours, the age range of 6-12 years old, and clinical manifestation of diarrhea. On the other hand, evidence of chronic disease, zinc supplementation within three months before hospitalization, and duration of diarrhea more than seven were considered the exclusion criteria. This study was approved by the ethical committee of the university. Results Out of 160 participants (80 cases and 80 control), 89(55.6%) cases were male, and 71(44.4%) subjects were female. The mean age of the participants was 3.35±2.21 years (aged 1-10 years). There was no difference between case and control groups in terms of age and gender. The mean zinc level was significantly lower in cases (72.76±26.39) than in controls (91.15±17.76). Zinc level in children aged < 5 years was significantly less in the case group compared to that in the control group, while in children aged > 5 years, no significant difference was observed(P=0.85). Conclusion As evidenced by the obtained results, serum zinc level was significantly lower in children with gastroenteritis compared to that in their counterparts without this problem.

The rate of missed care depends on several factors which can affect the quality of care and treatment. The present study was conducted with aim to investigate the relationship between missed care, work environment and patient safety culture. This cross-sectional study was conducted on 380 nurses working in the teaching hospitals affiliated to Jundishapur University of Medical Sciences in Ahvaz, Iran. Sampling was done through a stratified random sampling method from Jan 2019 to Jul 2020. The data collection tools included a demographic data form, the Missed Nursing Care Questionnaire, the Practice Environment Scale of the Nurse Work Index, and the Hospital Survey on Patient Safety Culture. Data were analyzed using SPSS software (version 25) and one way ANOVA, Pearson correlation and Kolmogorov-Smirnov tests. p<0.05 was considered statistically significant. Three most prevalent missed nursing care were overall patient assessment in each shift (96.1%), administering the drugs up to 30 minutes before or after the scheduled time (94.7%), and measuring the vital signs as ordered (94.1%). The mean scores of missed care were significantly higher among nurses with lower ages (p<0.0001) and less work experience (p<0.0001). A significant inverse correlation was found between missed care and the overall score of patient safety culture (r= -0.22, p<0.0001). Also, a significant correlation was found between missed care and the overall score of the work environment index (r=0.285, p<0.0001).Implications for Practice: Nursing managers can reduce the rate of missed nursing care by improving the working conditions of nurses and educating them about patient safety.

Up to 25% of children with epilepsy experience resistance to treatmentand recurrence of seizures and have low quality of life (QoL) in various dimensions. Limited evidence isavailable on the QoL of the parents of these patients in the south of Iran. Therefore, this study aims toevaluate the QoL of parents with children having refractory epilepsy in Ahvaz, Iran

Using a sequential sampling method, 157 parents of 113 children with refractoryepilepsy who referred to the neurology clinic of Golestan Hospital in Ahvaz city during 2009-2016 wereselected to participate in the study. The 36-item short form health survey (SF-36) was used to assess theQoL of parents. The significance level of statistical tests was set at 0.05.

The mean age of parents was 35.2±8.5 years and the mean age of children was 7.1±2.6 years. Of157 parents, 98 (62.4%) were mothers and the rest were fathers. The children had seizures for 3.1±1.6years. The mean score of SF-36 was 62.6±21.4. In all domains of the SF-36, mothers had significantlylower scores than fathers (P<0.000).

The QoL of parents with children having resistant epilepsy, especially their mothers, in Ahvazis lower compared to the general population of Iranian

The increasing trend of hearing loss is an important public health concern that needs coordinated and well-designed measures at the regional, global, and local levels. We determined the audiological profile of a province in Iran with unique socioeconomic, ethnic, and geographical characteristics and investigated the risk factors associated with hearing loss.

A total number of 1845 participants (35–70 years old) were recruited in the current prospective study. Pure tone audiometry and tympanometry tests were conducted to determine the type and severity of hearing loss in adults living in southwest Iran (Arab ethnicity). The hearing loss prevalence in individuals with a history of head trauma, cardiovascular disease, noise exposure, diabetes, and smoking status was compared with that of disease-free participants.

The hearing loss prevalence was 51.3% (947/1845), which was significantly correlated with sociodemographic factors, including age, gender, marital status, educational level, skill levels, wealth status, Townsend deprivation index, and smoking habit (p<0.001). The hearing loss prevalence showed a significant association with a history of diabetes, cardiovascular disorders, smoking habits, head trauma, and noise exposure (p<0.05). Nonetheless, the prevalence of hearing loss and the type of residency, and the wealth index were not significantly associated.

Hearing loss causes the burden of chronic disability in southwest of Iran. Several socioeconomic, demographic, and medical parameters influence the consequences of hearing loss.

Feelings of loneliness can affect the mental health of the elderly and lead to cognitive problems. As a potentially effective treatment approach, cognitive-behavioral therapy (CBT) has emerged as an intervention to alleviate loneliness among the elderly. This study aims to determine the effect of CBT on alleviating loneliness among elderly women referred to health centers in Khomeini Shahr.

Methods & Materials: 

This quasi-experimental study was conducted in 2020 on a sample of 60 elderly women who had been referred to health centers in Khomeini Shahr. The participants were conveniently selected and then randomly assigned to either the intervention or control groups. Data were collected using a demographic information form and the Deshiri et al’s loneliness questionnaire, which were administered before, immediately after, and one month after the intervention. The intervention group received eight counseling sessions of CBT that lasted for 60 minutes each, while the control group did not receive any counseling. Data analysis was carried out using the SPSS software version 23, employing descriptive and inferential statistics.

The results obtained from conducting a two-way repeated measures analysis of variance (ANOVA) showed a significant statistical difference in the mean score of loneliness resulting from communication with family, the score of emotional symptoms of loneliness and the total score of loneliness in the intervention group before and after the intervention (P<0.001). However, no statistically significant difference was observed in the control group (P>0.05). Furthermore, when comparing the mean score of loneliness resulting from communication with friends in the intervention group, no statistically significant difference was observed before and after the intervention (P=0.094). Similarly, no statistically significant difference was observed in the control group (P=0.338).

The results of the current study indicate that CBT is an effective approach to alleviate loneliness in elderly women. Therefore, it is suggested that this method be implemented as a means to reduce feelings of loneliness among elderly women.

Cardiovascular disease is one of the most common causes of death in diabetic patients, affecting almost equally men and women. Identifying the determinants of myocardial infarction in elderly diabetics is necessary to apply proper preventive or control measures. The aim of this study was to determine the prevalence and risk factors associated with Myocardial Infarction (MI) in elderly diabetics in Hovayzeh district in 2016.

Data of diabetic patients aged 60 to 75 in the Hoveyzeh Cohort were analyzed according to potentially influential factors: age, sex, marital status, family history of MI, smoking, Body Mass Index (BMI) and hypertension. We performed multiple logistic regression model to identify variables related to MI.  The significance level was set at 0.05. Statistical analysis was conducted using IBM SPSS.

A total of 552 subjects were included in the study. Among them, 331(60%) were female and most (72.1%) of them were married. The mean age of participants was 64.5 ± 3.2 years. The prevalence of MI was 6.7 [95% Confidence Interval (CI) = 4.6 - 8.8]. In adjusted analyses, MI was associated with hypertension (OR 2.10, 95% CI; 1.03-4.32), smoking (OR 2.50, 95% CI; 1.28-4.89), family history (OR 2.82, 95% CI; 1.22-7.82) and BMI (OR 1.08, 95% CI; 1.02-1.48).

This study revealed that high blood pressure, family history of MI, cigarette smoking and BMI were significantly associated with the risk of MI in diabetic elderly. We recommend preventive measures and effective strategies for high risk group in diabetic elderly.

 Blastocystis hominis is an enteric protozoan in humans and animals. This survey aimed to assess the knowledge and practice of physicians about B. hominis.

 This study was performed on physicians working in Ahvaz County, using a convenience sampling method from January to June 2020. Data were collected through face-to-face interviews and an electronic questionnaire. Descriptive statistics, including frequencies and percentages, were calculated for all variables. P-values < 0.05 were considered significant.

 Our results showed that of the 352 physicians, 64.2% and 58.0% knew that B. hominis might cause abdominal pain and diarrhea, respectively, but their knowledge was poor about the possibility of extraintestinal clinical symptoms such as urticaria. Regarding the transmission route, 91.8% agreed that the fecal-oral route is the main mode of B. hominis transmission, but only 17.9% were aware of the role of host animals in its transmission. Furthermore, the physicians had poor knowledge of the need to treat symptomatic patients and resistance to metronidazole in some cases. More than two-thirds of the physicians (68%) had good practice treating infected immunocompromised patients but had poor practice treating symptomatic patients.

 This study emphasizes improving physicians’ knowledge of pathogenicity, clinical symptoms, and treating B. hominis. Since B. hominis is a common protozoan with pathogenic potential, we recommend training sessions for physicians to inform them of new findings about B. hominis.

The dietary approaches to stop hypertension (DASH) encourages high fruit, vegetable, and lean protein consumption and low salt, red meat, and fat intake to prevent or treat hypertension. However, besides hypertension, adherence to this diet has been shown to decrease other cardiovascular risk factors.

This study assessed the relationship between the DASH diet and cardiovascular risk factors in a cross‑sectional study of 2,831 adults chosen by multistage cluster sampling from 27 counties of Khuzestan province, Iran. DASH scores were calculated using data obtained from a qualitative food frequency questionnaire. Regression models were used to evaluate the association of DASH scores and common cardiovascular risk factors.

Significant trends were observed across quintiles of DASH scores for systolic blood pressure, fasting blood sugar, triglyceride, total cholesterol, and its components (p < 0·05). After adjusting for potential confounders such as sex, age, ethnicity, residence, wealth score, physical activity, energy intake, and family history of heart disease, the multiple regression analysis for each cardiovascular risk factor revealed that being in the highest quintile of total DASH score (OR = 0.72, 95% CI 0.52–0.99) was negatively associated with hyperglycemia.

This study showed a positive relationship between DASH diet adherence and lower serum levels of glucose, triglycerides, and cholesterol. Prospective studies are needed to confirm these findings.

The ideal combination regimen for Helicobacter pylori (HP) eradication has not yet been determined and the success rate of HP eradication has been extensively reduced worldwide due to increasing antibiotic resistance. So this multinational multi-center randomized controlled trial was designed to evaluate the efficacy of tetracycline +levofloxacin for HP eradication.

During a 6-month period, all of the cases with HP infection in eight referral tertiary centers of three countries were included and randomly allocated to receive either tetracycline + levofloxacin or clarithromycin plus amoxicillin quadruple regimen for two weeks. For all of the participants, pantoprazole was continued for 4 more weeks and after one to two weeks of off-therapy, they underwent urea breath test C13 to prove eradication.

Overall 788 patients were included (358 male (45.4%), average age 44.2 years). They were diagnosed as having non-ulcer dyspepsia (516 cases, 65.5%), peptic ulcer disease (PUD) (234 cases, 29.69%), and intestinal metaplasia (38 cases, 4.8%). Racially 63.1% were Caucasian, 14.5% Arab, 15.6% African, and 6.1% Asian. The participants were randomly allocated to groups A and B to receive either tetracycline + levofloxacin or clarithromycin. Among groups A and B in intention to treat (ITT) and per protocol (PP) analysis, 75.2% & 82.1% (285 cases) and 67.5% & 70.1% (276 cases) of participants achieved eradication, respectively (P = 0.0001). The complete compliance rate in groups A and B were 84.4% and 83.6%, respectively. During the study, 33.5% of the participants in group A (127 cases) reported side effects while the complication rate among group B was 27.9% (114 cases, P = 0.041). The most common complaints among groups A and B were nausea and vomiting (12.6% & 9.3%) and abdominal pain (4.48% & 2.68%), respectively. The rate of severe complications that caused discontinuation of medication in groups A and B were 2.1% and 1.46%, respectively (P = 679). In subgroup analysis, the eradication rates of tetracycline+levofloxacin among patients with non-ulcer dyspepsia, PUD, and intestinal metaplasia were 79.4%, 88.1%, and 73.9%, respectively. These figures in group B (clarithromycin base) were 71.3%, 67.6%, and 61.5% respectively (P = 0.0001, 0.0001, and 0.043).

Overall, the combination of tetracycline+levofloxacin is more efficient for HP eradication in comparison with clarithromycin+amoxicillin despite more complication rate. In areas with a high rate of resistance to clarithromycin, this therapeutic regimen could be an ideal choice for HP eradication, especially among those who were diagnosed with PUD.

Health literacy requires the knowledge, motivation, and competence to access understand, evaluate and apply health information to make judgments and decisions in daily life and to be prepared for the change to maintain or improve quality of life throughout life. This study aimed to investigate the health literacy level in the Iranian adult population (18-64 years old) and its relationship with behavior readiness. In this cross-sectional study, 898 people were live in Southwest of Iran participated in the study in February 2022. The random sampling method was simple. According to the number assigned to each client covered by the health center the online link of the questionnaire was sent to their mobile phone through SMS and WhatsApp. Data were analyzed by SPSS25. Only 30.3% of the subjects had excellent health literacy and 46.5% had adequate health literacy. The mean score of readiness for behavior change was 92.68 ± 13.31. Health literacy had a positive and significant correlation with readiness for change (r = 0.405, P <0.001). In general health literacy alone predicted 16.8% variance of behavior change readiness (R square = 0.168, adjusted R = 0.167, P <0.001).  In general health literacy in adults is insufficient. However, promoting health literacy may facilitate readiness to change health behaviors.

Estimating Fat-Free Mass (FFM) is an integral part of Body composition measurements, so obtaining an accurate estimation for evaluating FFM is critical for researchers and specialists. We aimed to develop and validate a simple equation for predicting FFM in the adult population.

Participants were 1996 adults (1085 men and 911 women), and 18 to 69 years old from Ahvaz City, southern Iran. They were randomly divided into the derivation (n=1396) and the validation (n=600) groups with no significant differences from Jan 2018 to Feb 2020. FFM was measured by Bioelectrical Impedance Analyzer (BIA) (InBody 770©; Biospace, Seoul, South Korea). Based on the demographic variables retrieved from the Derivation group, 8 FFM predictive equations were developed using multiple regression; finally, the most accurate model (using the coefficient of determination (R2)) was chosen and then validated on the Validation group for more evaluation.

The best equation derived from demographic characteristics was: " FFM= 0.28 × Weight (kg) + 0.57×Height (cm)+7.35×Sex (M=1, F=0)+0.03×Age (years)-70.61"; where sex = 1 for male and 0 for female. R=0.94, R2=0.89, standard error of the estimate=4.04 kg.

Our developed and cross-validated anthropometric prediction equation for fat-free mass estimation using BIA attained a high coefficient of determination, a low standard error of the estimate, and the lowermost coefficient of variation. Predictive equations may be reliable and valuable alternative methods for the clinical evaluation of fat-free mass in the adult population.

Social support has been found to positively influence the mothering experience. Yet little is known concerning primiparous mothers’ perceptions of social support following childbirth. This qualitative study aims to explore primiparous mothers’ perception and expectations regarding social support during the postpartum period.

This qualitative study with content analysis approach was conducted on 11 postpartum mothers who had been routinely referring to comprehensive health service centers in Kermanshah, Iran, from October 2020 to January 2021 for receiving postpartum care within the first 6 months after birth. Also, to further enrich the study data, interviews were conducted with healthcare providers (n = 6) and husbands (n = 3). Twenty‑two semi‑structured interviews were conducted individually through a purposive sampling method. Two participants were interviewed twice. Interviews were recorded and transcribed verbatim in Persian and analyzed using conventional content analysis.

Three main categories and thirteen subcategories emerged. The main categories were: “comprehensive support”, “support barriers,” and “support promotion strategies.” The main perception and expectation of mothers regarding social support was the sense of not being alone and receiving comprehensive support, especially from the husband and increasing his awareness about this support.

An understanding of a comprehensive support, support barriers, and support promotion strategies with respect to social support can help healthcare professionals to develop interventions and programs aimed at promoting mothers’ social support in the postpartum period.

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  minotransferase [ALT] and aspartate aminotransferase [AST]) among  eemingly healthy individuals.

The current  econdary 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.

The mean ±  tandard deviation age of participants was 38.65 ± 11.40 years. The  ajority 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:  5.57 ± 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  tatistically 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 <  .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  evels of PA in terms of mean concentration of AST was remained  ignificant (P = 0.003); however, the difference for ALT was not remained significant after adjusting potential confounders.

The current  tudy based on large sample showed that PA had a statistically negative  ssociation with the concentration of liver aminotransferases in the  eemingly healthy individuals; however, the observed associations were weak. People in the lowest levels of PA had the highest levels of ALT and  ST.

Age at menarche affects women’s health outcomes and could be a risk factor for some diseases such as Metabolic Syndrome. We assessed the association between age at menarche and metabolic syndrome components in women aged 35 to 70 in Hoveyzeh, southwest Iran. Study Design: A case-control study

This case-control study was conducted on 5830 women 35 to 70 years in the Hoveyzeh cohort study (HCS), a part of the PERSIAN cohort study, between 2016 and 2018. The case group was women with MetS, while the controls were women without MetS. Metabolic syndrome is determined based on standard NCEP-ATP III criteria. Data from demographic, socioeconomic, and reproductive history were gathered face to face through trained interviews. Also, lab, anthropometrics, and blood pressure measurements were assayed for participants. Multiple Logistic Regression was used to estimate the association between age at menarche and metabolic syndrome, with adjustment for potential confounding variables.

The mean age at menarche was 12.60 ± 1.76 years old. Urban and rural women differed in their age at menarche (12.58±1.71 and 12.63±1.83 years, respectively). A comparison of the four menarche age groups (≤10, 11-12, 13-14, 15-16 years) was statistically different between age at menarche and MetS. The odds of having metabolic syndrome for groups with menarche ages 13-14 years and 16-15 years, compared to women with a menstrual age ≤10 years, decreased by 21% and 20%, respectively.

The present study showed the effect of age at menarche on the odds of having MetS in women 35-70.

The use of separation tools from the mechanical ventilation device compared to the usual methods implemented in Intensive Care Units (ICUs) can reduce unsuccessful extubation. Therefore, this study was conducted with the aim of determining the impact of using the airway care score on the success rate of extubation in patients hospitalized in neurosurgical and neurologCal ICUs.

In this semi-experimental study, 98 patients with epidural, subdural and intra cerebral hemorrhage were selected based on the inclusion criteria and by convenience sampling method. According to the table of randomization blocks (permutation blocks) and by using the WinPepi software 11.4, they were randomized and assigned to two interventions (49 people) and control (49 people) groups. In the intervention group, extubation of patients was performed using the airway care score tool and in case of obtaining a score of seven or less. In the control group, patients were extubated based on the opinions and experiences of anesthesiologists.

In this study, the number of re-intubation cases in the intervention group was less than the control group, but this difference was not statistically significant (P=0.2). Also, the duration of connection to the mechanical ventilation device (P=0.02) and endotracheal tube (P=0.018) and the duration of hospitalization in the ICU (P<0.001) in the intervention group were significantly less than the control group.

The use of airway care score tool reduces the number of unsuccessful extubations but this difference was not statistically significant. Also, by using this tool, the duration of hospitalization of patients in neurosurgical and neurological ICUs, the duration of intubation and also the duration of connecting patients to mechanical ventilation were reduced. Therefore, due to the lack of awareness of nurses in ICUs about extubation tools and performing the extubation process in a traditional way, it is necessary to make necessary plans by relevant authorities to increase the awareness of nurses in this field.

Nasogastric tube (NGT) insertion in anesthetized patients and in patients with depressed levels of consciousness is a challenging process with a high rate of failure. Therefore, the current parallel clinical trial study was conducted with the aim of investigating the effect of the lateral position on the success rate of nasogastric tube insertion in patients with low level of consciousness.

The current study type was a randomized clinical trial in which 170 patients with low level of consciousness and admitted to intensive care and general departments of Ganjavian Hospital in Dezful city were randomly selected and divided into two groups using permutation blocks of six according to the inclusion criteria. Control (85) and intervention (85) were allocated. The data collection tools included demographic and medical information forms and checklists. SPSS version 16 was used for data analysis.

The results show that the duration of tube placement in the intervention group was 64.63 seconds and in the control group was 99.80 seconds, the most common complication is gag reflex in the intervention group 35.30% and in the control group 52.94% The placement of the first time in the intervention group was 63.53% and in the control group was 30.59%. Complications duringtube placement (P=0.002), time spent (P<0.0001), number of attempts to succeed in tube placement (P<0.0001) in the intervention group significantly less than the group Was in control. In general, the success rate of tube placement in the intervention group was significantly higher than the control group (P=0.001).

According to the findings of the present, using lateral position for NGT insertion in patients with depressed level of consciousness is recommended to the treatment team, especially nurses because this method reduces the complications and the number of attempts to achieve successful intubation, in addition to increasing the success rate and saving nurses’ time

Gestational diabetes mellitus (GDM) is associated with several consequences during pregnancy and later life. Few studies have focused on social factors related to gestational diabetes using combined indicators.

The data of the Hoveyzeh cohort study were used in this study. The studied population was women aged 35-70 from Hoveyzeh County, who were enrolled in the study between May 2015 and August 2017. Socio-economic status was investigated based on education level, occupation, wealth index, and Townsend's deprivation index. SPSS software was used for data analysis. To this end, normality, chi-square, and means comparison tests were used. Also, household asset status was determined using principal component analysis (PCA), and logistic regression was used to control confounding factors.

A total of 5477 participants had experienced one or more pregnancies. The prevalence of gestational diabetes among the participants was 4% (221/5477). Also, GDM had a prevalence of 4.9% and 2.7% in urban and rural women, respectively (p<0.001). The logistic regression test results showed that literacy level, urbanization, and the wealth index were significantly correlated with the prevalence of gestational diabetes.

The overall prevalence of gestational diabetes was relatively low among the participants. The higher prevalence of gestational diabetes in urban, more educated, and wealthier women can be due to differences in nutritional status, less physical activity, and more screening in these populations. Prospective studies are suggested to better understand the impact of social factors on the occurrence of gestational diabetes.

Clinical competence is one of the main goals of nurses' training which has a significant role on the quality of patient care. Therefore, identifying the related components can be effective in improving the quality of care. Spiritual health has also been considered as an important factor in the efficiency and success of nurses.The aim of this study was to determine the relationship between spiritual health and clinical competence of nurses working in teaching hospitals of Ahvaz Jundishapur University of Medical Sciences (2017).

Methods & Materials:

This descriptive-correlational study was performed with the participation of 165 nurses in teaching hospitals of Ahvaz by multi-stage sampling method in 2017. Data collection tools included a questionnaire of demographic characteristics, clinical competence and spiritual health. Data were analyzed using descriptive and inferential statistics in SPSS 22 statistical software.

The results showed that the level of clinical competence and spiritual health of the nurses was moderate. The results of Pearson correlation test showed that there is a significant and positive correlation between spiritual health and clinical competence of nurses (r=0.176, P=0.023) .Also, the field of quality assurance had the lowest average score and the field of education and management had the highest average score of clinical competence.

Considering the significant relationship between spiritual health and clinical competence of nurses, it is necessary to design appropriate educational programs for nurses' empowerment and in order to promote spiritual health and clinical competence of nurses.