fateme behmaneshpour

Consanguineous union is a common practice and the culturally preferred form of marriage in developing countries, including Iran, with several health-related and social adverse outcomes.

This study aimed to identify the prevalence of consanguineous marriages and their sociodemographic correlates among marrying couples living in Zahedan, southeast of Iran.

This cross-sectional study included 738 couples attending the Pre-Marriage Counselling Center in Zahedan, southeast Iran. All information was gathered during face-to-face interviews. Multivariate logistic regression models were fitted using the forward likelihood ratio method to identify the correlates of consanguineous marriages.

The prevalence of consanguineous unions was 46.7% of the total marriages. First-cousin unions were the most frequent type, comprising 30.2% of total marital unions. The average inbreeding coefficient (F) in consanguineous couples was calculated as 0.0516 (95% CI: 0.0481-0.0551). Consanguinity was found to be associated with ages younger than 20 years, lower levels of education, rural residence, Balouch and Sistani ethnicity, lower income, parental consanguinity, and marriages arranged by parents.

The results of this study showed that the tradition of consanguineous unions is still a preferred practice among people living in southeast Iran, especially among socioeconomically disadvantaged individuals. There is a need for health education programs to improve the knowledge of marrying couples about consanguineous marriages to reduce the potential risk of genetic disorders in offspring.

Effective blood transfusion is a life-saving practice in obstetrics and gynecology emergencies that can prevent blood product wastage in hospitals.

This study was performed to evaluate the appropriateness of the use of blood products in pregnant women in a tertiary care hospital in Zahedan, southeast Iran.

This cross-sectional study was carried out from September 2019 to March 2020 to assess the patterns of blood utilization in a tertiary care hospital in Zahedan, Iran. Blood bank registries and the data of 1,500 pregnant women were used for data analysis, using blood transfusion indices, including cross-matched to transfusion (C/T) ratio, transfusion probability (T), and transfusion index (TI).

Out of 1,064 units of requested blood products, 581 (54.6%) were cross-matched, and 774 (72.7%) were transfused to patients. The blood transfusion indices of C/T, T%, and TI were 2.11, 48.48%, and 0.76, respectively. The transfusion rate was 6.2%, and the commonest associated obstetrics complication requiring transfusion was uterine atony (32.2%), followed by anemia (17.2%). There was a statistically significant relationship between the type of delivery, uterine and placental problems, coagulation disorders during pregnancy, number of deliveries, and residence place, and the probability of blood transfusion (P > 0.05).

The overall blood utilization indices were encouraging; however, the proportion of blood wastage was relatively high. Regular auditing is needed to optimize the use of blood and blood products in obstetrics and gynecology departments.

Patients with heart failure (HF) need continuousmedical care, including regular follow-up, training, and information acquisition to increase self-care capacity. Adherence to self-care behaviors reduces patient readmission

This study examined the impact of the continuous care model (CCM) on self-efficacy and readmission of patients hospitalized with HF.

This quasi-experimental study was conducted on patients with HF visiting two teaching hospitals in southeastern Iran in 2021. The participants were 70 patients who were selected using convenience sampling and were placed into two control and intervention groups, each with 35 patients through limited random sampling. The patients in the control group received routine care, but the CCM was performed for the patients of the intervention group in the form of individual training for 6 sessions in the hospital and after discharge and then through telephone follow-up once a week until the end of the twelfth week. The instruments used to collect the data were a demographic information form that assessed patient readmission and their demographic information and Sullivan’s Cardiac Self-Efficacy Scale. The collected data were analyzed with SPSS software (version 22) using the chi-square test, independent and paired samples t-test, and analysis of covariance at the significance level of P < 0.05.

Analysis of covariance showed that the mean self-efficacy score of the patients with HF was significantly different between the two groups after implementing continuous care (P = 0.001). The results of the independent samples t-test suggested that the mean and standard deviation of readmission frequencies in the control group (1.03 ± 1.01) were significantly higher than the mean readmission frequencies of the patients in the intervention group (0.34 ± 0.68) (P = 0.001).

Given the positive and significant effect of the CCM on increasing patient self-efficacy and reducing the frequency of readmissions, and considering the ease, applicability, and low cost of this intervention, relevant authorities need to make effective planning and policies to implement the CCM for patients with HF.

Free-of-charge vaginal deliveries have been offered as part of the Health Transformation Plan (HTP) in Iran, but still a high proportion of deliveries are occurring at home. This study aimed to investigate the reasons for home deliveries after the implementation of HTP in southeast of Iran. This case-control study included women who gave birth at home between September 2015 and September 2016 for their last pregnancy; considered as cases (n=300), and women who delivered at a health facility (hospital or Safe Delivery Posts), assigned to the control group (n= 600). Data were collected during face to face interview using a 77-item semi-structured questionnaire. A multivariable logistic regression technique was used to identify independent predictors of home delivery. Women who were worried about giving birth at a teaching hospital (OR=1.9, 95% CI:1.3 -2.8), women with negative experiences in the previous delivery (OR=1.6, 95% CI:1.0-2.4), illiterates (OR=3.8, 95% CI: 2.0-7.4), individuals with primary/secondary education (OR=2.3, 95% CI: 1.3 - 4.4), women with no health insurance (OR=5.1, 95% CI: 3.5- 7.4), if the decision on choosing the place of birth was made by the women alone (OR=12.7, 95% CI: 7-22.8), women with financial constraints (OR=1.7, 95% CI: 1.2-2.4), women with precipitate labour (OR=2.4, 95% CI: 1.7-3.5) and women with fear of the hospital environment (OR= 1.6, 95% CI: 1.1- 2.4) were more likely to deliver at home. Our findings highlight socio-economic and cultural barriers that need to be addressed to reduce home deliveries among the disadvantaged women.

Celiac disease (CD) is a chronic, systemic immune disorder that can affect one’s quality of life.

The aim of this study was to explore the key performance indicators (KPIs) related to the quality of life of patients with CD admitted to the Celiac Association of Bouali Hospital in Zahedan.

This descriptive-analytical study was performed on 60 patients with CD who referred to the Celiac Association of Bouali Hospital in Zahedan in 2018. Data collection tools included a demographic questionnaire (age, gender, marital status, duration of illness, education, ethnicity, economic status, occupation, breastfeeding history, family history of CD, as well as vitamin D and iron supplementation) and the Quality of Life Questionnaire for patients with CD. Data were analyzed in SPSS 21 using descriptive statistics. All values less than 0.05 were considered statistically significant.

Sixty participants completed the study, 66.7% of whom were female, 76.7% weremarried, and 85.3% reported a family history of CD. The total score of patients’ quality of life was 81.66± 18.33, and the lowest score of quality of life was associated with patients’ concerns (51.81 ± 3.85). The findings also showed that, among various KPIs, vitamin D had a particularly significant relationship with patients’ quality of life.

There was a significant relationship between the quality of life and vitamin D supplementation in the participants. Besides, considering the effect of physical health on improving the quality of life and the chronic nature of CD, it is necessary to enhance the quality of life of these individuals by raising their awareness aboutmicronutrient intakes while respecting their dietary restrictions.

Healthcare workers (HCWs) regularly face the risk of exposure to sharp injuries and splashes as an occupational hazard, which presents a major risk for acquiring blood-borne infectious agents..
This study aimed to determine the occurrence of needlestick injuries (NSIs) and other high-risk occupational exposures to blood and body fluids (BBFs) among HCWs in three teaching hospitals affiliated with the Zahedan University of Medical Sciences..
Patients and A cross-sectional study was carried out from March 2013 to December 2014. Information on self-reported incidents, circumstances surrounding occupational exposure, and post-exposure management were collected from an ongoing surveillance system. Descriptive statistics and chi square tests were used for data analysis..
A total of 236 incidents of occupational exposure were registered during the study period. Nurses (82, 34.7%) were most frequently exposed to BBFs, followed by physicians (57, 24.2%). Two hundred and nineteen (92.8%) of the personnel sustained NSIs, and 17 (7.2%) had splashes to mucus membranes. The incidents were most frequently reported from the internal medicine ward (19.1%) followed by the operating theater (17.1%). Subjects with splashes to mucus membranes were more likely to postpone seeking medical advice following exposure, as compared with needlestick cases (23.5% versus 5%, P The relatively high prevalence of percutaneous injuries and splashes in this study emphasized the importance of improved prevention strategies, better hospital surveillance for occupational exposure, and enhanced training of healthcare workers..

Although Iranian women increasingly attend hospitals for childbirth, no information is available on programs and practices related to infection control in labor and delivery units..
This study aims to investigate infection control program management and midwives’ practices in labor and delivery units..
Patients and We analyzed data related to infection control program management and also practices performed by 88 midwives in four labor and delivery units in public hospitals in Zahedan, southeast Iran..
The evaluation scores for all aspects of infection control were suboptimal; infection control program management 38.1% to 71.4%, healthcare workers post-exposure measures 58.5% to 92.7%, medical waste management 73.9% to 87.0% and infection control related standard infrastructures and equipments 55.9% to 82.8%. The midwives mean scores for attending infection control training courses and hand hygiene were less than 40% of the maximum score, but the mean scores for normal vaginal deliveries scrub, and equipments and instruments hygiene practices were generally above 70%..
The results of this study revealed a need for development of appropriate policies and protocols for infection control practices in labor and delivery units and also midwives training on clean delivery practices..

Healthcare-acquired infections (HAIs) that patients develop during the course of healthcare treatment are important causes of morbidity and mortality worldwide..
The aim of this study was to determine the epidemiology of HAIs in a tertiary-care teaching hospital in Zahedan, southeast Iran..
Patients and This was a cross-sectional study of patients admitted to Ali-Ibn-Abitalib Hospital, a tertiary-care teaching center, from March 2013 through March 2014. All patients admitted during this study period were examined by head nurses on a daily basis for detecting four types of HAIs: surgical site infection, urinary tract infection, pneumonia, and bloodstream infection. All the identified HAIs were registered into the Iranian National Nosocomial Infections Surveillance System Software. Pathogens were identified using standard microbiological methods, and antimicrobial susceptibility was determined by disk diffusion tests according to the Clinical and Laboratory Standards Institute guidelines. Descriptive statistics were used for data analysis..
A total of 16,140 patients were admitted to the hospital during the study period, including 162 found to have HAIs (approximately 1%). The majority (79.6%) of the HAIs were reported from the intensive care units (n = 129), followed by the medical wards (10.5%, n = 17) and obstetrics/gynecology ward (7.4%, n = 12). The most common site of infection was the respiratory tract (67.9%) followed by the urinary tract (13.6%). Among the pathogens isolated, Acinetobacter and Enterobacter were the most common (17.6%) followed by Escherichia coli (11%). Overall, multidrug resistance was observed in 95% of the isolates..
The HAI prevalence found in this study was lower than HAI rates reported in some other studies from Iran. The isolates showed high resistance to common antibiotics. Guidelines for improving HAI surveillance and stringent measures to reduce the prevalence of multidrug-resistant HAIs must be implemented to reduce the rate and the consequences of HAIs..

Providing high-quality maternity services is crucial to increase utilization of these services and reduce maternal mortality. The quality of the maternity services provided to pregnant women in rural areas of Iran is poorly understood.. This study aimed to investigate the quality gap in the maternity care services provided by Rural Delivery Facilities and Safe Delivery Posts in Sistan and Balouchestan Province, southeast of Iran, as expressed by the difference in women’s perceptions and experiences of services..Patients and In this cross-sectional study a total of 438 pregnant women who gave birth in rural maternity unit were recruited between February and May 2013. The SERVQUAL questionnaire was used for data collection. The Wilcoxon Signed-Rank test was used to compare the quality gap as expressed in the mean of differences in the expectation and perception scores. The quality gap was compared between demographic groups using Kruskal-Wallis tests.. There was a negative gap in all dimensions of the quality of services provided. The highest quality gap was found for the reliability dimension followed by tangibles, empathy, assurance and responsiveness. The participants’ age, levels of education, and the type of maternity unit were found to be associated with the clients’ perceived quality of services.. The quality gap in the services provided by maternity units showed that these units are not able to meet pregnant women’s expectations completely. The negative quality gaps can be used as a guideline to improve the maternal health care quality and reduce maternal mortality, particularly in high-risk women such as those living in rural areas..