فهرست مطالب elham maraghi

Culicidae plays a crucial role in the spread of diseases like Malaria and arboviral diseases such as Japanese Encephalitis, Zika virus, Chikungunya, Dengue fever, Yellow fever, and West Nile fever. Different mosquito species have different abundance and distribution due to a variety of factors, such as physicochemical factors, weather conditions, vegetation, and human activities. The characteristics of larval habitats are among the factors affecting the population, and diversity, and determining the preferred breeding places of the species. For this reason, a study was conducted to examine the species diversity of Culicidae and their larval habitats in Shushtar County.

This cross-sectional study was conducted in Shushtar County from the central, Mian Ab and Shuaibiya districts, 2021. Larvae were collected from the breeding places in the sampling areas including Noormohammadi, Konarpir, Saheli, Abu Gerva, and Pirdalu by using the dipping technique in spring and summer and kept in lactophenol solution. Then, a microscopic slide was prepared from the samples using licidophor, which were identified with valid diagnostic keys. Characteristics of larval habitat such as habitat type, water condition, vegetation, substrate type, water quality, and light condition were also recorded. To analyze the data and determine the relationship between the frequency and characteristics of larval habitats, SPSS version 16 software and a chi-square statistical test were used. Qualitative variables were also reported as numbers (percentages). Abundance and distribution maps of samples were prepared using ArcGIS software version 10.5.

In this study, a total of 527 larvae were identified, including five species of Anopheles stephensi, Culex pusillus, and Cx. sinaiticus, Cx. theileri and, Cx. Perexiguus. Anopheles stephensi with the lowest frequency (8.48%) was reported only from the Saheli area. This species was collected from temporary, stationary, without vegetation, mud substrate, cloudy water, sunny, and natural habitats. Culex theileri, one of the important vectors of arboviral diseases, was observed in temporary and natural habitats, stagnant waters without vegetation, and cloudy and sunny waters habitates. Culex pusillus was the only species observed in Pirdalo and Abu Gerva. By examining the larval habitats of Culicidae in Shushtar County, Cx. pusillus was the most abundant collected species, from temporary habitat (82.7%), stagnant waters (73.6%), mud substrate (100%), turbid waters (78.6%), natural (95%), and sunny (82.7%). Also, the abundance of collected larvae in temporary habitats, stagnant waters, in areas with vegetation, and mud substrate was high. Besides, it was more abundant in turbid waters and sunny areas, and these differences were statistically significant (P<0.0001).

In this study, Cx.pusillus was the most common species, while An. stephensi was the least common abundance among collected species. It was observed significant difference between this species and the type of habitat, water flow, vegetation, water quality, and light conditions. Conducting more comprehensive studies in this field, especially regarding the possible role of different species of Culicidae, helped to solve the health and medical problems of humans and veterinary medicine in the future.

 There is a paucity of research investigating the changes in thyroid hormones in individuals affected by coronavirus disease 2019 (COVID-19).

 This study aimed to evaluate the levels of thyroid hormones in individuals affected by COVID-19 infection in Ahvaz, Iran.

 This was a comparative cross-sectional study on 78 patients with COVID-19 infection and 80 individuals without infection. Thyroid-stimulating hormone (TSH), triiodothyronine (TT3), and tetraiodothyronine (TT4) were measured in hospitalized patients at baseline and one month after recovery and in participants without infection. The data were analyzed using a paired t-test, the Chi-square test, the Wilcoxon test, and the analysis of covariance (ANCOVA).

 The level of TSH at baseline in the hospitalized patients was significantly lower than that in the control group (1.24 ± 1.08 vs. 2.05 ± 1.02 mlU/L, respectively, P < 0.0001). The mean level of TT3 was 1.20 ± 0.24 and 1.28 ± 1.25 ng/dL in the case and control groups, respectively (P = 0.188). The level of TT4 in the case group was high at baseline in comparison to the control group (8.48 ± 2.27 vs. 7.76 ± 1.43 ng/dL, P = 0.076), which was reduced in the follow-up period. Thirty-five (44.8%) patients had severe disease and were admitted to the intensive care unit (ICU). The level of TSH was non-significantly lower in patients with severe disease than those with moderate disease.

 Patients with COVID-19 infection showed abnormalities in thyroid hormones, such as decreased levels of TSH and TT3. Patients with severe COVID-19 showed lower levels of TSH and unchanged levels of TT3 and TT4 in comparison to the patients with moderate disease. Further investigation into thyroid function in patients with COVID-19 is recommended.

 There is evidence supporting the effectiveness of mirror therapy (MT) in improving pain and function in the upper limbs. However, there are limited studies that validate its effectiveness in enhancing function and reducing pain among individuals with chronic back pain.

 This study aimed to assess the effect of motor correction exercises with and without MT on pain intensity and disability in patients with chronic low back.

 This randomized clinical trial study was conducted on 72 participants with chronic back pain referring to physiotherapy centers affiliated with Jundishapur University of Medical Sciences, Ahvaz. Specific exercises using MT were performed in the intervention group (36 participants) and without it in the control group (36 participants) for 10 weeks. The condition of the patients before and after the intervention and 3 months after the intervention was evaluated using a chronic pain questionnaire, pain intensity, and Oswestry index. The data were analyzed using SPSS version 22, employing descriptive and inferential statistical methods. A significance level of P ≤ 0.05 was used.

 A significant difference was observed between the groups for the variables that showed pain intensity after treatment (P = 0.001) and the difference remained in the follow-up (P = 0.003) Chronic pain after treatment and the difference at follow-up [-0.41 (-3.45 to 2.47), P = 0.001] and disability remained after treatment [-2.6 (-5.6 to 0.5); P = 0.02] which indicates the effectiveness of MT.

 Based on the results, MT was effective in reducing the pain intensity and disability experienced by patients with chronic back pain. As a result, considering its affordability and ease of access, patients can perform the exercises independently after receiving proper instruction and guidance.

Chronic kidney disease (CKD) is defined by a glomerular filtration rate (GFR) or markers of kidney damage persisting for more than 3 months. In Iran, the age-adjusted prevalence of CKD is 14.9%, based on the published literature. It has emerged as a significant health concern associated with morbidity, mortality, and a diminished quality of life.

The present study aimed to assess the survival rate and its predictors in hemodialysis patients.

The data were collected from teaching hospitals affiliated with Abadan University of Medical Sciences between January 2002 and December 2017. The patient survival period was plotted using Kaplan-Meier survival curves. The Cox regression model was employed to analyze the influence of various variables on the desired time.

A total of 389 patients were included in the study. Among them, 79% were married, and 229 (60.1%) were illiterate. The probabilities of 1-, 5-, and 10-year survival of the patients were 0.92, 0.46, and 0.02, respectively. The Cox regression model revealed that the risk of death in hemodialysis patients with hypertension was 1.45 times higher than in those without hypertension. Additionally, factors such as rural residence, older age, using permanent catheters, high serum creatinine, and blood urea nitrogen (BUN) levels increased the adjusted hazard ratio in hemodialysis patients.

After adjusting for confounding factors, this study demonstrated a significant association between advancing age, hypertension, using permanent catheters, and reduced survival rates in patients with end-stage renal disease (ESRD).

Transferring patients from intensive care units to general units can increase anxiety in patients and their families, which can lead to re-admission of patients in intensive units and increase hospitalization costs.

The present study was performed with aim to determine the effect of the transition nursing program from intensive care units to general units on the anxiety and satisfaction of patients and their families.

This randomized clinical trial study was conducted on 50 patients hospitalized in surgical ICUs and 50 of their relatives. The research units were randomly assigned to the intervention and control groups. Before transfer, patients and their families filled out the Spielberger and satisfaction questionnaire. Then, the transition nursing program was implemented and the patient was examined by the liaison nurse immediately, 8, 16 and 24 hours after transfer. Then, the questionnaires were filled out again. Data were analyzed by SPSS software (version 22). p<0.05 was considered statistically significant.

After the implementation of the nursing transfer program, the anxiety of patients (34.68±8.02) and their families (32.52±7.84) reduced in the intervention group compared with the control group (p<0.0001). Also, the satisfaction of the patients (47.64±5.65) and their families(45.56±6.10) significantly increased in the intervention group (p<0.000).

Implications for Practice: 

The transition nursing program reduces anxiety and increases the level of satisfaction in patients and their families. The findings of the present research can be suggested to the policymakers and nursing managers in order to plan to improve the role of nurses as liaison nurses.

People with knee osteoarthritis have a low quality of life due to joint pain and stiffness, severely limiting their daily activities. This study aims to investigate the impact of self-acupressure on the pain, joint stiffness, and physical functioning of patients with knee osteoarthritis.

This randomized clinical trial was conducted on 78 patients aged 50 to 70 with knee osteoarthritis, referred to Imam Khomeini Hospital and private orthopedic clinics in Ahvaz City, Iran, in 2018. The patients were recruited based on the inclusion criteria and then randomly assigned to three groups: self-acupressure (n=26), sham (n=26), and control (n=26). Patients in the intervention group applied daily self-acupressure to 5 specific points around their knees for 8 consecutive weeks. The sham group applied pressure on the points different from those used by the intervention group. The control group received no intervention. The study data were collected using the Western Ontario and McMaster osteoarthritis index (WOMAC), visual analog scale (VAS), and a checklist for daily recordings of pain medication. The obtained data were analyzed using the chi-square test and analysis of variance in SPSS software, version 20. The significance level was set at P<0.05.

The comparison of changes within the group showed that the intensity of pain in the intervention group decreased over time (P<0.0001). Also, the joint stiffness, physical functioning, and total WOMAC score significantly decreased in the intervention group (P<0.0001). The frequency of analgesic use was also reduced in the intervention group over time (P=0.026).

According to the results, self-acupressure effectively reduces the intensity of pain and joint stiffness and improves the physical performance of older adults with knee osteoarthritis. Overall, this easy and affordable intervention is recommended for this group.

Recently published researches show that 59% of all transmission came from asymptomatic transmission and at the time of diagnosis health‑care workers (HCWs) tend to present without respiratory symptoms. These evidences have raised questions on whether an essential policy for use of personal protective equipment (PPE) is the best approach in HCW and other people or not. Therefore, this study conducted to investigate the effectiveness of using face masks and PPE in reducing the spread of COVID‑19 in health‑care and non‑health‑care settings. This systematic review and meta‑analysis study was prepared according to the preferred reporting items for systematic review and meta‑analysis statement and guided by meta‑analysis of observational studies recommendations. Searches in databases were conducted from December 2019 to July 2021. Random‑effects meta‑analysis was performed to investigate the effect of using face masks and PPE on spread of COVID‑19. Heterogeneity among studies was assessed using Cochran’s Q test and the I2 metrics. In total, 9920 individuals from 14 studies were included in this study. In all settings, application of PPE or any type of masks was associated with reduction in risk of COVID‑19 (odds ratio [OR] = 0.44; 95% confidence interval [CI]: [0.29, 0.65]; I 2 = 85.21%). In the HCW subgroup, the protective effect had a combined OR of 0.33 (95% CI: (0.15,0.73), I2 = 82.61%). Six studies were found protective effects of wearing mask in non‑HCWs (OR = 0.58, 95% CI: (0.31, 1.06), I2 = 85.63%). Results suggest that there is association between face mask/PPE use and reduction of COVID‑19.

A high-risk pregnancy (HRP) is adversely affects the health of the mother, baby, or both.Most prenatal care research, rather than quality concepts, focuses on the adequacy of prenatal careand describes the emotional-psychological experiences of women with HRP. The main purpose of thisstudy was to explore the perspectives of healthcare professionals regarding the quality of prenatal carefor women with HRP. This qualitative study was conducted in three university hospitals and 12 comprehensivehealth centers in Ahvaz (Iran) from December 2020 to May 2021. In the present study, 10 midwives,2 executive directors, and 7 specialists were purposefully selected with maximum diversity. In-depthsemi-structured individual interviews were used to collect the data. Data were analyzed concurrentlyusing Elo and Kinga’s content analysis. The MAXQDA software version 10 was used for data analysis. During data analysis, the 6 main categories “infrastructure for care provision”, “optimalclinical care”, “organizing referrals”, “preconception care”, “risk assessment”, and “family-centeredcare” and 14 subcategories were identified. Our findings showed that professional groups focused on the technical aspects of caring.The findings from this study highlight several conditions that can affect the quality of prenatal carefor women with HRP. Healthcare providers can use these factors to effectively manage HRPs, therebyimproving pregnancy outcomes among women with HRPs.

Fatigue and re-admissions are the important consequences of heart failure that cause limitations in patients’ daily activities, personal, and social affairs. Energy conservation techniques are among evidence-based and non-pharmacological approaches that can reduce fatigue in patients with chronic disease.      

The present study was performed with aim to determine the effects of tailored energy conservation training on fatigue and readmissions of patients with heart failure (HF).

This randomized clinical trial study was performed from May 2019 to March 2020 on 96 patients with HF admitted to CCU and cardiovascular clinics affiliated to Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Patients who met the inclusion criteria were randomly assigned to the intervention and control groups. A three-part tool (demographic-clinical questionnaire and need assessment), the Fatigue Severity Scale (FSS) and a readmissions record checklist were used to collect data. After determining the training needs of each individual, the intervention group received five 45-minute face-to-face individual training sessions of energy conservation strategies reinforced by telephone support every two weeks and followed up for 12 weeks. The control group only received routine post-discharge training. Fatigue scores by FSS and the readmissions recorded were tested at baseline and three months after the end of the intervention.

At baseline, the two groups were comparable in the mean hospital admissions and fatigue scores. However, after the intervention, the mean frequency of hospital admissions and the mean fatigue score were significantly lower in the intervention group (1.36±1.26, P< 0.001; 2.86±1.01,P< 0.001) than in the control group (0.42±0.77, P< 0.001; 5.25±1.03, P< 0.001) respectively.

Implications for Practice: 

Nurses and physicians are recommended to teach energy conservation methods to patients with HF and chronic conditions who are prone to fatigue and its side effects.

Preterm Birth (PTB) is one of the leading causes of infant morbidity and mortality. Prenatal care is an effective way to improve pregnancy outcomes but there is limited evidence of effective interventions to improve perinatal outcomes in disadvantaged pregnant women. This review was conducted with the aim to assess the effectiveness of prenatal care programs in reducing PTB in socioeconomically disadvantaged women.

We searched the Scopus, PubMed, Web of Science, and Cochrane Library databases from January 1, 1990 to August 31, 2021. The inclusion criteria included clinical trials and cohort studies focusing on prenatal care in deprived women with the primary outcome of PTB (< 37 weeks). Risk of bias was assessed using the Cochrane Collaboration’s tool for assessing risk of bias and the Newcastle–Ottawa Scale. Heterogeneity was evaluated using the Q test and I2 statistics. The pooled odds ratio was calculated using random‑effects models.

In total, 14 articles covering 22,526 women were included in the meta‑analysis. Interventions/exposures included group prenatal care, home visits, psychosomatic programs, integrated intervention on socio‑behavioral risk factors, and behavioral intervention through education, social support, joint management, and multidisciplinary care. The pooled results showed that all types of interventions/exposure were associated with a reduction in the risk of PTB [OR = 0.86; 95% confidence interval: (0.64, 1.16); I</em>2 = 79.42%].

Alternative models of prenatal care reduce PTB in socioeconomically disadvantaged women compared with standard care. The limited number of studies may affect the power of this study.

Psychological Distress (PD) is one of the most common mental disorders during pregnancy and involves stress, anxiety, and depression. According to the literature, High‑Risk Pregnancy` (HRP) is a major physiological risk factor associated with PD during pregnancy. The main purpose of this study was to explore the perception and experience of women with HRP who, based on standard questionnaires, had moderate‑to‑severe stress and anxiety scores.

This qualitative study was conducted using conventional content analysis from December 2020 to June 2021. To this aim, 16 women with HRP were purposefully selected from Imam Khomeini Hospital in Ahvaz, Iran, with maximum diversity. In‑depth, semi‑structured, individual interviews were conducted to collect the data. The MAXQDA software was used for data analysis.

Data analysis led to the extraction of two main categories and nine subcategories. “Disrupted peace” and “inefficient adaptation to the situation” were the two extracted categories. The former included the five subcategories of concerns about pregnancy complications, concerns about the parenting process, concerns about the couple’s relationship, fear of Covid‑19, and occupation‑related stress. The latter included the three subcategories of unpleasant feelings, current pregnancy experiences, and previous pregnancy experiences.

This study highlighted a wide range of psychosocial factors involved in the PD of women with HRP. These findings can be used to design appropriate prevention strategies to manage the mental health problems of these women in order to turn their pregnancy into a pleasurable experience.

The intensive care unit memory (ICUM) assessment tool is a practical tool for memory monitoring after the discharge from ICU.

This psychometric study purported to validate ICUM for a sample population of Iranian patients hospitalized in ICU.

This research was a descriptive-analytical study that was conducted at Ahvaz University of Medical Sciences in 2022. A total of 96 patients were selected through the convenience sampling method and were asked to complete the questionnaire 2 weeks and 8 weeks after their discharge from the hospital. Exploratory factor analysis was run to validate the tool’s structure. The reliability of the ICUM tool was checked by the testretest method and the Cronbach alpha coefficient for memory subscales.

To increase the qualitative face and content validity of the tool in Persian, some vague items were modified according to the suggestions of the participants, language, and nursing experts. For the quantitative face validity, the item coefficient was calculated, and the minimum score obtained was 4.4. For the quantitative content validity, the content validity ratio (CVR) and content validity index (CVI) were calculated. The minimum obtained scores were CVI=0.7 and CVR=0.6. Thus, all the items were confirmed. The implementation of the factor analysis was confirmed with KMO=0.65. The highest Cronbach alpha coefficient for delusional memory was 0.62 and the highest test-retest correlation for factual memory was 0.95.

The Persian version of ICUM has strong test-retest reliability, but weak internal consistency reliability. It is recommended that future studies evaluate the tool’s reliability over an extended period.

Natural disasters, such as floods provide the basis for spreading vector-borne diseases by creating environmental changes. This study aims to investigate the common vector-borne diseases during floods in Khuzestan Province, Iran, in 2019 and the strategies and challenges to control them.

This research is applied objectively and it is a descriptive survey in terms of collecting data using a qualitative method. The statistical population in the qualitative section included 15 experts from health centers in Khuzestan Province with a history of presence in flooded areas who were purposively selected using the snowball technique. The data collection tool was a semi-structured interview.

Qualitative data were categorized into 5 categories of common arthropods, common vector-borne diseases, vector control strategies and challenges, and organs involved in vector control programs during floods. The most common arthropods were lice, mites, mosquitoes, flies, and scorpions. The most prevalent vector-borne diseases during the flood were scabies, pediculosis, mosquito bites, and scorpions. The critical challenge was the lack of national vector control guideline in disaster condition.

Considering the history of floods and health problems caused by these natural disasters, it is necessary to recognize the common vector-borne diseases, develop national guidelines, and provide solutions to deal with them.

Pediculosis, caused by Pediculus spp is an important public health problem in urban and rural areas around the world. Natural compounds such as plant essential oils (EOs) have been suggested as a potential alternative for insect pest control recently. The purpose of this study was to investigate the toxicity of Foeniculum vulgare essential oil against the head louse, Pediculus capitis under laboratory conditions.

Fennel essential oil components were analyzed using GC-mass apparatus. Immersion and contact filter paper bioassays were used to evaluate fennel essential oil toxicity at the two-fold concentrations of 2.5, 5, 10, 20, and 40% against nit and nymph/adult stages of the head louse.

Trans-anethole, α-Thujone, and limonene, which consisted of 76.08%, 10.37%, and 5.34% were the most com ponents of fennel oil respectively. The LC50 values for the adult /nymphs were 11.5, 6.4, 3.9, 3.1 and 2.5% and LC99 values were 29.5, 15.2, 12.8, 10.8, and 7.4% at 10, 20, 30, 45 and 60 minutes after exposure respectively. The le thal times (LT50) for adults/nymphs were 5.2, 8.1, 9.5, 20.5, and 45.8 minutes and LT99 were 138.6, 91.3, 23.8, 21.7, and 13.9 minutes in the concentrations of 2.5, 5, 10, 20 and 40%, respectively. LC50 and LC99 values were 2.32% and 7.36% after 5 days for the eggs.

Fennel essential oil at the concentration of 15% after 20min is suggested to develop as an appropriate for mulation to evaluate in clinical trials.

According to the American Heart Association and American Stroke Association (AHA/ASA) guidelines, in acute stroke, the door-to-computed tomography (CT) scan (DTC) time should be less than 25 minutes, and time to injection of recombinant tissue-type plasminogen activator (r-tPA) [door-to-needle (DTN) time] should be less than 60 minutes.

We had a tendency to prospectively collect the clinical and time information of patients who received r-tPA during one year after the initiation of prehospital notification (PN). Patients were divided into three groups, covering patients transferred by Emergency Medical Service (EMS) with and without PN, and non-EMS. We then contrasted the impact of EMS with PN and EMS use on onset-to-needle time (ONT), and the neurological outcome. Good outcome was determined as Modified Rankin Scale (MRS) ≤ 2 at 3-month follow-up.

Among 102 studied patients, 64% were transferred by EMS, of whom 53.9% entered PN. Compared with non-PN groups, EMS with PN group showed significantly shorter DTN and DTC time, as well as ONT.

Our study showed that EMS with PN, rather than EMS, significantly improved stroke outcome by shortening of ONT.

Importance of hand hygiene with the COVID-19 has been raised around the world from 2019. We aimed to determine the effect of hand skin health in menopausal women during the covid-19 pandemic.

It was a cross-sectional study which has conducted on 94 subjects those were referred to menopause clinic in Imam Khomeini Hospital in Ahvaz city during September to November 1999. The tools of this study were the Personal Characteristics Questionnaire and Hand and skin self-assessment tool (Appendix 3 of “WHO GUIDELINES ON HAND HYGIENE IN HEALTH CARE “). Data has entered and analyzed by using software SPSS version 22. The level of significance was considered as less than 0.05.

The mean age of women participating in the study was 53.6. The average frequency of hand washing outdoors was 5.28 and 10.43 indoors. Most women (94.7%) had reported at least some degree of skin problem and reported that their hand skin problems increased significantly during the COVID-19 pandemic.

Finding this study has shown that about 95% of women had felt at least one problem in their hands. During COVID-19 pandemic, hand washing with disinfectants were repeated more and more, furthers skin of the hands will be two times more damaged as compared to normal conditions, so the need to increase hand health training as part of general health, especially in older adults' women in advance.

In many studies, Cox regression was used to assess the important factors that affect the survival of cancer patients based on demographic and clinical variables. The aim of this study was to determine the factors affecting the survival of patients with Hodgkin's lymphoma using the random survival forest (RSF) method and compare it with the Cox model.

In this retrospective cohort study, all patients with Hodgkin's lymphoma who were referred to the Oncology and Hematology Center of Ahvaz Shafa Hospital from March 2000 to February 2010 were included. The survival time was calculated from diagnosis to the first recurrence event date (based on month). To assess the process of the disease, demographic characteristics and disease-related variables (including disease stage, chemotherapy, site of lymph involvement, etc.) were extracted from the records of 387 patients with Hodgkin's lymphoma. To investigate the prognostic factors that affect the recurrence of disease the Cox model and RSF were implemented. Moreover, their performance based on the C-index, IBS, and predictor error rate of the two models were compared Data analysis was implemented by using R4.0.3 software (survival and RandomForestSRC packages).

The results of the Cox model showed that LDH (P=0.001) and classical lymphoma classification (P<0.001) were associated with an increased risk of relapse in patients. However, the results of the RSF model showed that the important variables affecting the recurrence of disease were the stage of disease, chemotherapy, classical lymphoma classification, and hemoglobin, respectively. Also, the RSF model showed a higher (c-index=84.9) than the Cox model (c-index=57.6). Furthermore, the RSF model revealed a lower error rate predictor (0.09) and IBS index (0.175) than the Cox model. So, RSF has performed better than the Cox model in determining prognostic factors based on the suitability indicators of the model.

The RSF has high accuracy than the Cox model when there is a high number of predictors and there is collinearity. It can also identify the important variables that affect the patient's survival.

Transmission routes of COVID-19 have been well identified and documented. Considering the high prevalence of the Covid-19 and its impacts on the population, this study aimed to assess the status of preventive behaviors against coronavirus infection and estimate the odds of its transmission routes among people.  

A comparative study was conducted from March to April 2021. A total of 1256 participants were randomly selected, including 262 COVID-19 patients and 994 healthy people from 10 counties in Khuzestan, southwest Iran. A two-part questionnaire was used for data collection that included items on demographic and adherence to preventive behaviors. Statistical analysis was performed using the statistical software SPSS 18.0.0 applying logistic regression.   

The mean age of participants was 37.60±11.48 years (female: 36.49±11.15 years; male: 38.86±11.74 years). The results showed that having contact with infected patient at home (OR = 4.90, 95%CI = 3.32-7.25), going to the hospital for not-necessary medical reasons (OR = 4.47, 95%CI = 3.05-6.55), leaving home for essential daily services (OR = 2.49, 95% CI = 1.63-3.81), and going to doctors' office (OR = 1.78, 95% CI = 1.20-2.63) could increase the odds of infection.   

The findings suggest that different factors are responsible for the increased spread of the Covid-19. Indeed, since the intervention for every single factor will have a small contribution to reducing the prevalence of the disease, it seems essential to design comprehensive interventions while emphasizing isolation and contacts tracing. The study provides evidence for multi-level and multi-faceted policy and interventions for promoting adherence to COVID-19 preventive behaviors.

Bipolar disorder type I is a chronic and recurrent disease and is considered as the ninth nonfatal disease. Identifying the symptoms of the manic episode, which are more likely detected by patients, increases the ability of psychiatrists in diagnosing this disorder.  

In this cross-sectional study, a total of 96 patients with bipolar disorder were enrolled from 2 academic psychiatric centers. Then, using the patients’ medical records, demographic data were collected. Further, both the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview and the Young mania rating scale (Y-MRS) scale were also performed. Then, about 27 to 33 days after discharge, the patients were contacted by phone and the SCID-I interview was conducted again. Meanwhile, to make the patients focus on the period from which they have recently improved, the phrase “the recent period of hospitalization” was added to the interview questions and the symptoms were checked.  

At the beginning of the hospitalization, the most common symptom in the total population was irritable mood (89.5%): in the male population decreased need for sleep (98.2%), and in the female population irritable mood (97.5%). In addition, in the evaluation, about 1 month later, irritable mood (69.7%) and decreased need for sleep (67.7%) were the most common symptoms detected by the patients. In terms of the predictive value of each symptom to the diagnosis of that symptom by the psychiatrist, the highest positive predictive value was related to the symptoms of irritable mood (95.5%), decreased need for sleep (95.4%), and talkativeness (95.2%). However, the highest negative predictive value was related to the symptom of elevated mood (87.5%).  

The patients who have passed manic episodes are more able to detect some symptoms of this episode. Despite some limitations, it seems that using these statistical findings in practice may promote clinical assessment and diagnosis of bipolar disorder type I by psychiatrists.

Several measures have been taken to prevent the onset of ventilator-associated pneumonia (VAP), one of which is measuring the gastric residual volume. The purpose of this study is to compare the effect of two tube feeding methods with and without gastric residual volume measurement on VAP.
This clinical trial was performed on the study population of patients with endotracheal tubes hospitalized in Intensive Care Units 1 and 2 of Golestan hospital, Ahvaz, Iran. Overall, 70 patients who met the inclusion criteria were randomly divided into groups 1 and 2. Groups 1 and 2 were fed with and without measuring gastric residual volume, respectively. The incidence of pneumonia was assessed using the Modified Clinical Pulmonary Infection Score prior to the intervention and on the fifth day post-intervention. The data were analyzed by the SPSS software version 22.
The incidence of VAP was 9.12% in the group with gastric residual volume measurement and 7.14% in the other group. There was no significant difference between the two groups (P=0.827) regarding VAP prevalence.
Monitoring gastric residual volume requires aspiration and repeated measurements of gastric contents, resulting in increased nursing workload. Moreover, if the gastric residual volume is high, the patient will be deprived of calorie intake and subjected to malnutrition. As a result, removing the monitoring of gastric residual volume from the care setting and focusing on interventions proven to reduce VAP can be more helpful.

Disease management approach is an effective means in genetic disorders, such as sickle cell disease (SCD). This disease is a neglected chronic disease of increasing global health importance. In this process, acquiring knowledge and information related to the disease plays a critical role in self-efficacy and self-care. Therefore, one of the determinants of health and criteria for enhanced quality of life is health literacy.

Therefore, the present study aimed to determine the relationship between the quality of life and health literacy associated with disease management among patients with SCD.

This descriptive-correlational study was conducted on 150 patients with SCD in Ahvaz. These patients have been referred to the thalassemia clinic and the thalassemia ward of Shahid Baghaei-2 Hospital and selected via accessible sampling. The study data were collected using WHOQOL-EREF-26 items and a researcher-made questionnaire about information resources whose reliability and validity were confirmed. Then, the data were entered into the SPSS software and analyzed via descriptive statistics, chi-square, regression, and correlation tests.

The mean age of the participants was 27.56 ± 9.14 years. The most important resource for increasing knowledge was the physician in 83.3% of the patients. In addition, they had acquired the highest amount of knowledge about the causes and symptoms of the disease. Moreover, the highest and lowest mean scores of quality of life were related to physical health (50.80 ± 9.94) and (45.23 ± 19.91) social health dimensions, respectively. The results showed statistically significant differences between the place of residence with the dimension of social health (P = 0.037, b = -11.05) and sources of knowledge enhancement with the dimension of social health quality of life (P = 0.010, b = -14.96).

Since quality of life is a subjective and multifactorial concept, its effective factors have to be explored. The present study results indicated that the patients were eager to acquire knowledge about their disease. The higher the patients’ knowledge level, the higher their ability in disease management, self-care, and social health dimension of quality of life would be.

Today, E-learning is an integral part of the education system, which has become a practical tool for implementing educational programs in many universities due to its many benefits and Covid 19 epidemic. The aim of this study is evaluating the quality of virtual education from the point of view of Ahvaz Jundishapur University of Medical Sciences students. The information of this descriptive-analytical study was collected using a researcher made questionnaire with five main components including educational content, technological infrastructure, educational environment, evaluation and feedback and interaction between student and teacher based on Likert scale. Data analysis was performed using SPSS version 22 Software. After determining the validity and reliability of the questionnaire, it was completed by 404 students. The mean of educational content 20.75±10.29, technological infrastructure 13.50±5.89, educational environment 18.31±6.61, evaluation and feedback 26.80±6.85 and interaction between student and teacher 16.64±5.73, were reported medium, medium, medium, good and medium, respectively. The general satisfaction of students was calculated with the virtual education method in the Navid system 5.49±2.59 and the review and supervision of the Education Development Center on the quality of educational content provided 2.56±1.43. Considering the economic, educational, cultural and temporal benefits of virtual education, it is suggested that in the coming semesters and in the post crisis period, university officials and policy makers have the necessary planning for combined education.

Pain is the most crucial reason to seek treatment, and acupressure is one of the most common ways to relieve pain; therefore, this study was conducted with the aim to investigate the effectiveness of acupressure on the reduction of pain and stability of physiological indexes in addicted men.

The present single-blind, randomized, clinical trial was performed on 90 participants who were hospitalized in an addiction treatment camp in Masjed-e-Soleyman, Iran. The participants were divided into acupressure group (n = 45) and control group (n = 45) through allocating permutation blocks method. The acupressure group received acupressure on SP6 and ST36 points for 3 consecutive sessions and each session for 10 minutes. The data collection tools used included a demographic information questionnaire, the Short-Form McGill Pain Questionnaire (SF-MPQ), and a physiological index registration form, tympanic thermometer, sphygmomanometer, pulse oximetry device, and digital watch. Repeated measures ANOVA was used to analyze the data. P ≤ 0.05 was considered statically significant.

There was a statistically significant decrease in the sensory dimension of pain in the acupressure group compared to the control group in all 3 sessions (P ≤ 0.001; P ≤ 0.001; P = 0.001, respectively). There was no statistically significant difference in the overall pain score (P ≥ 0.005), emotional pain dimension (P ≥ 0.005), and physiological indexes of pain (P ≥ 0.005) between the two groups after the intervention.

Acupressure is a non-invasive and cost-effective method that reduces the sensory dimension of pain, and its application does not require special tools; thus, the use of such a safe and secure method for relieving pain is recommended.

E-learning is a process in which information and communication technologies are used to design, manage, present, guide, exchange, support and develop learning. The purpose of this study is to identify factors affecting the willingness of faculty members to use e-learning. The criteria and sub-criteria based on which faculty members use e-learning were extracted from previous studies. Matrix tables of these criteria and sub-criteria were prepared and completed by faculty members working in the university on an hourly basis and the weight of the criteria and sub-criteria was determined using Expert Choice 11. Comparison of factor weights in independent subgroups was performed using Mann-Whitney test. The mean age of participants was 44.37± 7.64 years, and the majority of them (60.4 %) were men. The weights of personal, pedagogical and administrative / legal criteria were 0.395, 0.281, and 0.138, respectively. The following sub-criteria were the most important factors affecting the willingness of faculty members to use e-learning: Computer self-efficacy, skill in producing electronic content, poor information of professors in using information technology, lack of culture and publicizing for virtual teaching, and lack of policies, plans, and executive rules in this respect. E-learning is a special and exceptional opportunity that can be successful by removing the existing barriers and considering incentives and supportive factors for its use and application by faculty members and universities.