masoud karimloo

COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Older age, male gender, chronic respiratory diseases, cardiovascular diseases, diabetes mellitus, high blood pressure, chronic kidney and liver disease, Immunocompromised conditions, malignancies, excessive obesity, disabilities, and pregnancy are risk factors for severe illness or death in COVID-19 patients.

This study aimed to evaluate the results of medical care and factors affecting the recovery and death of patients hospitalized in three hospitals affiliated with the Islamic Azad University of Tehran/Iran.

This is a retrospective study, and the information is obtained from the files in the medical records unit of the hospitals. The study was conducted on 1255 covid-19 patients hospitalized in 3 hospitals affiliated with the Islamic Azad University of Tehran Medical Sciences. In the retrospective study, information was obtained from the files in the medical records unit of the hospitals using the researcher's checklist. The checklist included demographic findings and variables related to the severity of the disease, immune status, underlying systemic diseases, cardiovascular and respiratory diseases, and variables related to the consequences of the disease. The data was analyzed using SPSS. Qualitative variables were analyzed using frequency and percentage. The chi-square test was used to examine the relationship between variables, and logistic regression was employed to assess this relationship.

In this study, the following items were significantly more prevalent in those who recovered: Compliance with home quarantine, dry cough, positive CRP, and presence of ground glass opacity images in CT scan. Moreover, the following items were more evident in those who died: High blood pressure, cardiovascular diseases, headache, myalgia, arthralgia, weakness, fatigue, insomnia, hoarseness, purulent sputum, lobar pneumonia, low Glasgow Coma Scale (GCS), seizures, anemia, high erythrocyte sedimentation rate (ESR), increased prothrombin time (PT), decreased serum albumin, and the presence of crazy-paving on CT scan. In all of the above items, P-values were ≤ 0.05.

It is suggested that patients hospitalized with symptoms, signs, and conditions commonly seen in cases of dying patients should receive more frequent monitoring and care.

Most care needs of aged people, residing in nursing homes, are provided by formal caregivers. The aim of this study was to determine the effects of storytelling on the knowledge of formal caregivers about aging and their attitudes towards aged people and caring for them at the nursing homes in the city of Shiraz.
This was a semi-experimental study with pretest and post-test and follow-up design, which was implemented in the nursing homes of Shiraz City. The sample size included 47 formal caregivers. Both the “Facts on Aging Quiz” and the “Cogan’s Attitudes towards Older People Scale” instruments were used in this study. Content validity ratio, content validity index and reliability of the instruments were confirmed. Five storytelling sessions were held for each group. During each session, according to the predetermined training program, one story or a myth with respect to the work experience with aged people was presented. This persuaded the care givers to share their related experiences, knowledge and memories with other participants. Data were analyzed using SPSS 16.
The mean scores of attitude toward elderly were 108.23, 111.38 and 111.95 at pre-test, post-test and follow-up stages, respectively. The mean scores of knowledge of the facts of aging were 9.04, 9.87 and 10.46 at pre-test, post-test and follow-up, respectively. Storytelling increased knowledge and more positive attitude of caregivers toward aging (P Using storytelling improved care-givers’ formal knowledge and attitudes towards their aged and care. Designing training programs based on the method of storytelling and executing them in nursing homes is recommended.

This paper aims to evaluate and select the optima method for treatment of heart diseases among the five methods including chemotherapy (anti-clotting medications)، bypass (open heart surgery)، angioplasty (inserting balloon)، and inserting heart battery. These methods are different in terms of a number of criteria including treatment duration، pace maker، ICD، severity of symptoms، cost، need for rest and absence from work، patients proclivity and required facilities for their implementation. This paper aims to evaluate and choose the best method of treatment among these five methods depending on the above mentioned criteria by using TOPSIS multi-criteria decision making technique. Methods & Materials: Thirty experts considered the five treatment methods based on six criteria and used a bipolar scale of 1 to 9 in order to evaluate each method based on each criterion. Then، after forming a decision-making matrix، the five methods were prioritized and the best was chosen through a six-stage process of the improved TOPSIS. The method of chemotherapy (anti-clotting medications) ranked as the first priority with proximity coefficient of 0. 659797 and hence could be offered to the patients as the most favorable treatment. Other methods were prioritized as follows: angioplasty with proximity coefficient of 0. 654508، ICD with proximity coefficient of 0. 650213، Pace Maker with proximity coefficient of 0. 52096 and bypass with proximity coefficient of 0. 293259. According to the study findings، as chemotherapy (anti-clotting medications) is close to positive criteria and far from negative criteria was selected to be the most suitable method of treatment of heart disease.

The aim of the current study was to translate and cross-culturally adapt the Swedish Occupational Fatigue Inventory (SOFI) into Persian and to evaluate its face and convergent validity.Method & Material: A methodological study was performed according to standard IQOLA protocols, including the following steps: translating the SOFI questionnaire, evaluating the quality of the translation, back-translation and comparison of the English version with the Persian version by the original developer. The translated version was completed by 200 nurses. The Persian version of the Modified Fatigue Impact Scale (MFIS) questionnaire was used to evaluate the convergent validity. Spearman’s correlation was used to evaluate the correlation between the items. On the whole, the translations of the sentences were easy. The quality of the translation including the ‘clarity of translation, common language use, conceptual equivalence, and overall translation quality’ of the items was good. Face validity of the questionnaire was acceptable and did not lead to multiple changes in the questionnaire. Spearman’s correlation coefficient showed a high correlation between the total SOFI score and total (Persian) MFIS score (r=0.71 and p<0.01). The Persian version of the SOFI has acceptable face and convergent validity and is ready for further evaluation of its reliability.

Psychotic disorders have special importance within different psychiatry disorders، for both the individual and familial problems as well as economical and social consequences. The most widespread of them is Schizophrenia and Affective Psychotic Disorders، which often start in early ages and usually need expensive treatments while lacking sufficient prognosis. The aim of this study is determining the effects of risk factors on the severity of symptoms of illness in the first-episode psychosis patients who were admitted to Roozbeh Hospital in a 2-year follow up study. In this longitudinal study، first-episode psychosis patient’s data who were admitted to Roozbeh Hospital between 2006– 2008، were analyzed. The effect of variables such as type of treatment، age، gender، marital status، educational status، profession، family history of illness and the main diagnosis، on the severity of symptoms of illness was studied using transitional model in “R” software V2. 15. 0. Type of treatment، profession and the main diagnosis has significant effect on patient’s response. Underscoring the meaningful variables on patient’s response in care duration could be useful for better recognition of the treatment status of these patients’ and could help in presenting more suitable interventional programs.

Early diagnosis of cognitive disorders in order to initiate new efficient treatments in time is an important task which cannot be fulfilled without proper cognitive screening tools. The Clock Drawing Test (CDT) is a simple inexpensive cognitive screening tool which can be used in primary care settings delivering health services to older people. The aim of this study was to assess validity and reliability of the CDT in Iranian older population. Method and Materials: In this study the CDT and Mini Mental State Examination (MMSE) were concurrently performed on 74 literate participants aged 60 and over. Participants were recruited from the clients of Iran Alzheimer’s Association (dementia patients and non-demented clients، including other patients or care givers) during a 5 month period. The CDT was performed by two trained raters using Shulman’s six points scoring method. Using SPSS version 20، reliability was assessed measuring kappa statistics as well as ICC. Concurrent validity between CDT and MMSE were statistically analyzed by spearman’s rank correlation coefficient. Mean age of the participants was 72 years in a range of 60 to 90 years with equal numbers 0f male and female participants. Kappa statistics for test retest reliability was 0. 554 (p<0. 001). ICC for inter rater reliability was 0. 964 (p<0. 001). Spearman’s rank correlation coefficient for MMSE and CDT scores was 0. 782، statistically significant at p<0. 001. CDT is a valid and reliable test in literate older people that can be used as a cognitive screening tool in Iranian older population.

Several studies indicate that amyloid ß (Aß) peptide deposits and neurofibrillary tangles have key roles in pathogenesis and progression of the late-onset Alzhimer’s disease. Likewise it has been shown that inflammatory reactions play a significant role as well. Inflammatory mediators such as complement، chemokines and cytokines activators and inhibitors can release from activated microglia and astrocytes، causing neuronal dysfunction and death. One of the most important cytokines is tumor necrosis factor–α (TNF-α). This study was designed and carried out to determine the association between sporadic Alzheimer’s disease and the human TNF- α and APOE gene variations in Iranian population.

In this case – control study، the role of TNF-α gene polymorphism was determined in 167 sporadic AD patients and 163 healthy controls. Genomic DNA was extracted using standard salting –out method from peripheral lymphocytes and TNF-α -850C/T promoter polymorphism was genotyped using PCR/RFLP technique. Comparing the genotype and allelic frequencies were analyzed using chi-square and logistic regression tests by SPSS 11. 5.

The obtained results indicated that the frequency of TNF-α -850 heterozygote genotype (CT) was significantly higher in AD patients comparing healthy controls (p=0. 038). Although no significant difference were observed in TNF-α -850 homozygote genotype (TT) and T allele between the studied groups. No interaction was shown between TNF-α -850 and APOE gene polymorphisms as well.

These data suggests the role of TNF-α -850 TC genotype as a risk factor for AD in Iranian population. Although to show the effects of homozygote genotype (TT) and T allele، a study with a larger sample size maybe indicated.

ObjectiveNeuromuscular characteristics in Down syndrome result in generalized muscular hypotonia, developmental delays and sensory integration deficits. The aim of this study was to compare the effects of simultaneous sensory stimulations and current occupational therapy approaches on motor functions development of infants with Down syndrome.Materials & MethodsEighteen infants with Down syndrome, aged 6 -18 months, were evaluated in two groups: intervention group (simultaneous sensory stimulation and occupational therapy) and control group (occupational therapy alone). They attended the program 3 times a week for 6 months and each session lasted 45 minutes. Motor functions were assessed before, during, and after intervention in the two groups, using GMFM test.ResultsMean motor function increased in both groups according to the GMFM test (P = 0.000). Comparison of the changes showed that although the mean difference of this variable was higher in the intervention group, the difference was not statistically significant (P = 0.576).Mean motor deficit reduced in both groups during the period of the study,which was statistically significant (P < 0.05). Comparison of the difference in mean motor deficit in the first and last evaluations showed that this difference was more in the intervention group but statistically insignificant (P = 0.617)ConclusionEarly use of simultaneous sensory stimulations can improve the quality of motor skills in Down syndrome infants. It is suggested that it may be used as an early intervention in association with other methods in the rehabilitation of these patients. However, more studies in this regard are warranted.

The aim of this study was to examine the effect of language proficiency in the severity of dysfluency in Kurdish-Persian bilingual stutterers. In the analytical study, 31 Kurdish-Persian stuttered students with a mean age of 10 years and nine months were selected using convenience sampling. Language proficiency and the severity of dysfluency in the two languages with regard to indexes of language complexity, lexical diversity and Stuttering-like Dysfluencies Scale, were obtained using analysis of spontaneous speech, and were compared together. Language complexity in Persian, (including Mean Length of Utterances, length of five long sentences, number of verbs in the sentence, and number of dependent clauses in the sentence) were higher than in Kurdish significantly. Also, lexical diversity was higher in Persian than in Kurdish, but the difference was not significant. Participants stuttered in both languages, and the severity of dysfluency was higher in Persian than in Kurdish. The dominant language was Persian, due to incessant and compacted training of the language to students. Lack of teaching the mother tongue to these students at school, had weakened their learning, and brought about unequal conditions for learning both languages. The severity of dysfluency was higher in the dominant language (Persian), due to psychosocial factors (such as the participant's viewpoints on Persian culture and language, and their motivation for learning it). Probably due to the provision of courses in Persian, the participant's negative experiences regarding this language were higher and they had a more severe stuttering in this language for the same reason. A positive emotional relationship with the mother tongue could also be one reason for this condition.

Health is the base for socio-economic development and is the most important component of social welfare. Women’s health status, particularly, mothers’ health, is more vulnerable than men, in Iranian society. Evidences, resulted from different researches, indicate that health is related to socioeconomic determinants more than medical and nursing interventions. The term of Social Capital is a new concept in social sciences that during a short time, has been populated in literatures of social determinants of health. Social capital is consisting of the individual's participation in collective life and trust between them, which can enhance their human capital. In this article we looked the health as human capital. This study aims to explore relationships between individual measures of social capital and health, among mothers with children under age of 7 who attend the Abdolabad Health Site in south of Tehran. A cross- sectional design was used. 80 randomly samples were selected from mothers who attended to mentioned Health Site to attain preventive health services. Using “Shortened Version of Social Capital Assessment Tool” (SASCAT) we measured two basic dimensions of social capital: structural (group membership, social support and citizenship activities) and cognitive social capital (trust, social harmony, sense of belonging, sense of fairness). “SF-36” health questionnaire was used to measure two main components of health - physical and mental health – and also 8 health subscales: physical functioning(PF), role- limitations due to physical health problems(RP), bodily pain(BP), general health(GH), vitality(VT), social functioning(SF), role limitations due to emotional problems(RE) and mental health(MH). Partial Correlation Coefficient was applied to explore association between social capital and health. The study found low levels of group membership, social support and citizenship among the mothers. The findings indicate that, the study samples show medium scores of cognitive social capital and poor structural social capital. Mother's physical health was better than their mental health. The sample had the highest (best) mean scores for physical functioning (PF) and they showed the lowest (worst) mean scores for role limitations due to emotional problems (RE). Maternal cognitive social capital had statistically positive significant relationships with their physical health (r=0/45, p= 0/000) and also mental health (r=0/37, p= 0/001), but structural social capital had negative association with mental health(r=- 0/26, p= 0/027). In this study, positive relationship between maternal cognitive social capital and their health was notable. We conclude that the quality of human relationships (cognitive social capital) play more effective role than the quantity of them in maternal health....

Elderly people often suffer from disturbed sleep and Traditional Chinese acupressure is a noninvasive technique that employs pressure and massage to acupoints in order to stimulate the balance of life energy that promotes health and comfort. The purpose of present study was to determine the effectiveness of acupoints massage in elders experiencing sleep disturbances.

In this quasi experimental study which was applied as single blind clinical trial, Pittsburgh Sleep Quality index (PSQI) questionnaire was used as a screening tool to select individuals with sleep disturbance by purposeful sampling. Then the individuals were assigned to three groups by balanced randomized method (an acupressure group, a sham acupressure group and control group). Each group had 30 subjects and gender ratio was equal in three groups. The same massage was used in the acupressure group and the sham acupressure group, whereas only conversation was employed in the control group. Time of interventions was limited to 15 min. One course of intervention lasted for 3 days per week. These interventions were carried out for 4 consecutive weeks. After intervention 77 persons completed the questionnaire. Repeated measure ANOVA, ANCOVA and Kruskal-Wallis tests were used for data analysis.

The analysis of data post intervention showed significant differences in PSQI subscale scores of the subjective sleep quality (P=0.025), sleep duration (P=0.012), sleep efficiency (P=0.022), sleep disturbance (P=0.025), daily performance (P=0.033), sleep latency (P<0.001) and global PSQI scores (P<0.001) among three groups. POST HOC comparison showed significant differences in PSQI subscales scores and global PSQI scores in the acupressure group compared to control group (P<0.05). Whereas, there was significant difference only in PSQI subscales scores of the sleep latency (P=0.006) and global PSQI scores (P=0.021) in the acupressure group compared to the sham acupressure group. Sleep log data showed significant decrease of awake time and improving the quality of sleep in acupressure group (P<0.001).

This study confirmed the effectiveness of acupressure in improving the quality of sleep of elderly people and offered a nonpharmacological therapy method for sleep-disturbed elderly people.