فهرست مطالب mohammad rafi bazrafshan

Dyslipidemia is a major public health issue worldwide characterized by changes in lipid index such as cholesterol, Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL) and triglycerides (TG).This manuscript aimed to investigate the associated factors of dyslipidemia in Fasa Persian cohort study.

This cross-sectional study was conducted on the baseline data of Fasa Persian cohort with an initial sample size of 10129 subjects (35-70 years old) in 2021 in Iran. Univariate and multivariate logistic regression models were used to assess the relationship between covariates and dyslipidemia.

The number of males in this study was 4572 and the number of females was 5557. The prevalence of dyslipidemia in them was 40.8% and 27.7%, respectively (p-value < 0.001), and the prevalence of dyslipidemia in the whole study population was 3407 (33.6%).  Dyslipidemia was also more common in alcoholics, opium users, smokers, high glycemic index and higher body mass index (BMI). Men were 1.68 times more likely to have dyslipidemia than women. Opium and cigarette smokers were 1.15 and 1.36 times more likely to have dyslipidemia than non-smokers, respectively. Also, as BMI increases, the likelihood of dyslipidemia becomes higher than the reference group (below 18.5), and people with a BMI greater than 30 have the highest obesity range.

This study showed that the prevalence of dyslipidemia in the studied population was higher in men than in women and several risk factors such as gender differences, body mass index, smoking and opium use are effective in the prevalence of dyslipidemia.

 Ischemia is one of the most common injuries that is usually caused by reduced blood flow to the tissues. Following this incident, the tissue becomes deficient in oxygen and nutrients, and energy production in the affected cells stops, eventually leading to cell damage, but there is also evidence that restoring blood flow to ischemic tissues can lead to extra tissue damage known as Ischemia Reperfusion Injury (IRI). In this study, we reviewed the relationship between vitamin C intake and ischemia/reperfusion injury to investigate the relationship between vitamin C intake and ischemia/reperfusion injury. The keywords “Vitamin C” or “Ascorbic Acid” and “Ischemic” or “Ischemia” and “Reperfusion” were used in this search. The results show that vitamin C has a positive effect on ischemia treatment in the renal tissue, brain, liver, intestine, lung, ovary, pancreas, and skin.

The coronavirus disease 2019 (COVID-19) pandemic affected working conditions in healthcare systems and caused occupational stress and challenges for the majority of healthcare workers (HCWs).

This study aimed to examine the prevalence of anxiety, depression, burnout, and career resilience and assess the personal and occupational risk factors contributing to psychological symptoms in Iranian HCWs during the COVID-19 pandemic.

Through a cross-sectional study, HCWs were surveyed within January to February 2022 to evaluate the prevalence of anxiety and depression (using the Hospital Anxiety and Depression Scale [HADS]), burnout (using the Maslach burnout inventory health services survey for medical personnel [MBI-HSS-MP]), and career resilience (using the Career Resilience Questionnaire [CRQ]). The correlation between demographic-occupational factors and psychological symptoms was analyzed. A total of 610 complete responses were received from Iranian HCWs.

Approximately 87.9% of HCWs had symptoms of both anxiety and depression (HADS score  11). The results indicated that most HCWs experienced various signs of burnout (i.e., emotional exhaustion, decreased sense of personal accomplishment, and depersonalization, respectively). The mean score for career resilience reported by the participants was appropriate; however, a fifth of the HCWs had poor career resilience. The highest scores of burnout, anxiety, and depression, in addition to the lowest scores of career resilience, were reported by intensive care unit (ICU) professionals.

Marital status, long daily working hours, night shift work, access to personal protective equipment (PPE), and direct exposure to patients with COVID-19 had a significant impact on the anxiety, depression, burnout, and resilience of the HCWs.

In late 2019, a new virus spread in China that led to an acute respiratory disease by lung involvement. The virus spread over time and affected many countries, including Iran. Hospital staff are also at high risk of being infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

The present study aimed to evaluate the seroprevalence of IgG class antibodies against SARS-CoV-2 in healthcare workers and to compare the risk of SARS-CoV-2 infection in coronavirus disease 2019 (COVID-19) ward staff with other hospital wards.

This cross-sectional study was conducted on medical staff at Gerash University of Medical Sciences. After sampling the participants in this study, the production of anti-SARS-CoV-2 IgG antibodies was evaluated using the enzyme-linked immunosorbent assay (ELISA) method. Demographic and other necessary information about patients were also recorded.

Out of 323 staff participating in this study, 130 (40.24%) were in inpatient wards [of which 26 (20%) were in the COVID-19 ward], 55 (17.02%) were in paraclinical wards, and 138 (42.72%) were in administrative wards. A total of 44 (13.6%) patients had anti-SARS-CoV-2 IgG antibodies. There was no significant difference in the prevalence of antibodies between the three groups, but a significantly higher prevalence of antibodies was observed in the COVID-19 ward subgroup with 6 (23%) positive antibody tests, compared to other wards (P-value = 0.023).

Due to the higher prevalence of anti-SARS-CoV-2 IgG antibodies in staff working in the COVID-19 ward than in other wards, more attention should be paid to health protocols and also emphasis on completing vaccination and monitoring the safety level of staff working in the COVID-19 ward.

Hepatitis B and C are now recognized worldwide as dangerous infectious diseases which impose many physical and economic problems on individuals, families, and society.

This research was designed to demonstrate the trends of hepatitis B and C in the south of Fars province, southern Iran, from 2015 to 2021.

The current research was a cross-sectional analytical study. All patients infected with hepatitis B and C from 2015 to mid-2021 were enrolled, and their information was registered in the health department of the Larestan Faculty of Medical Sciences. The Cochran-Armitage trend test was used to determine hepatitis B and C incidences.

A total of 306 cases of hepatitis B and 128 cases of hepatitis C were registered. Themean age of the individuals with hepatitis B was 40.15 ± 18.95 years, and that of those with hepatitis C was 45.12 ± 13.31 years. The overall incidence of hepatitis B and C was estimated at 18.44 and 7.71 per 100,000 population, respectively. The highest incidence of hepatitis B was observed, with 50.91 and 26.01 per 100,000 population in 2019 and 2018, respectively, and the lowest incidence was reported in 2016 (1.46 cases per 100,000 population). The highest incidence of hepatitis C, with 17.94and15.01 per 100,000 people, wasreported in 2018and2019, respectively, and the lowest incidence (0.36 per 100,000 population) was in 2016. The finding of the Cochrane-Armitage trend test for both types of hepatitis B and C indicated that the trend of hepatitis incidence from 2015 to 2021 had significantly increased (P Trend < 0.001).

In general, the incidence of hepatitis B and C has increased significantly; therefore, it is necessary to implement preventive and control programs.

People experience a lot of challenges during COVID-19 pandemic, and studies that have examined the effects of quarantining people exposed to COVID-19 in Iran are limited.

This study aimed to explore the people's experiences of psychological challenges of home-quarantine during the COVID-19 pandemic in southern in Iran.

In this descriptive qualitative study, 44 individuals who were voluntarily quarantined at home for at least two weeks due to the COVID-19 pandemic were interviewed in depth from the beginning of January to March 2021. Purposive sampling method was used to select the participants, and the conventional content analysis approach was used to analyze the data. Qualitative data management was performed using MAXQDA 10 software.

Most participants were 31- 40 years old (29.5%), had diploma (38.6%), were married (75%), and were female (56.8%). The extracted data were classified into 3 main categories (Individual psychological issues, social psychological issues, and family psychological issues) and 15 subcategories.

Due to the prevalence of COVID-19, measures such as home quarantine should be taken to control the infection, but it might have adverse psychological impacts on some people, as confirmed by the results of this study. Therefore, it is necessary to pay attention to the mental health of people during home quarantine, so that this method is more welcomed and successful.

Patients with beta thalassemia major face various challenges in physical and psychosocial aspects. The need for resilience capacity to overcome these challenges can be effective. Identifying factors affecting resilience can be considered as a framework for designing nursing interventions. The present study was conducted with the aim of determining the mediating role of hope in the relationship between spiritual well-being and resilience among adolescents with beta thalassemia major.

This was a descriptive-correlational study. The statistical population of the research included adolescents aged 11 to 21 years with beta thalassemia major who referred to thalassemia centers in Fars province in south of Iran in 1401, from which 288 participants were selected via convenience sampling method. Paloutzian and Ellison's spiritual well-being questionnaire (1982), Connor-Davidson resilience questionnaire (2003) and Herth Hope questionnaire (1992) were the instruments used in this study. Data analysis was conducted using descriptive tests, Pearson correlation, and a structural equation model in Spss-24 and Amos-24.

The results showed that all the fit indices are within the acceptance range of the model. The results obtained from structural equation modeling indicate a positive and significant effect between spiritual well-being and resilience (t=2.78, β=0.25), spiritual well-being and hope (t=2.31, β=0.32), and Hope with resilience (t=2.53, β=0.57). Finally, the indirect effect of spiritual well-being on resilience through hope is significant (p < 0.01, β = 0.052).

According to the results of this research, it is suggested to pay more attention to the promotion of spiritual health as a mechanism for improving hope and resilience in the care programs of these patients.

Dear Editor, COVID‑19, a deadly disease that started in December 2019 following a severe epidemic of severe respiratory disease in Wuhan, China,[1] and nearly two years later, on November 8, 2021, it swept across the world and infected more than 249 million people and caused more than 5 million deaths.[2] From the beginning of the disease in the world, the role of nurses in different parts of hospitals and helping to provide treatment for them has been very important, and nurses have been at the forefront of the fight against this pandemic.

Context: 

Research in the United States has shown that nearly a third of transgender adults have engaged in suicidal thoughts or behaviors. The present research was designed to comprehensively estimate the prevalence of suicidal behaviors in transgender people.

 The current research is a systematic review and meta-analysis of the prevalence of suicidal behaviors in transgender people. The technique of reporting the current research was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) list. In September 2020, the investigators surveyed six international sites: EMBASE, Medline/PubMed, Google Scholar, ProQuest, ISI Web of Science, and Scopus.

 The prevalence of suicide attempts in transgender people was 26.34% (95% CI for 22.54 - 30.13), and that of suicide ideation in these individuals was 44.26% (95% CI for 33.79 - 54.74). The results of the meta-regression of suicide attempts in recent years have shown a declining trend; nevertheless, this result was not statistically significant (P = 0.446).

 The prevalence of suicide attempts and suicide ideation in transgender persons is higher than in the overall population. However, this study showed that the prevalence of suicide attempts has been decreasing in recent years, and suicide ideation are increasing, but these findings were not significant, and more studies are needed to prove this issue.

In recent years, public confidence in vaccines has been decreasing. This study was conducted aiming at explaining the challenges of accepting the coronavirus disease 19 (COVID-19) vaccination by students.

This study is a qualitative content analysis. The samples were students who did not intend to get vaccinated against COVID-19. The applied data collection method was a semi-structured interview. Sampling continued until reaching data saturation. To analyze the data, first, the interviews were recorded and typed word by word. Then, they were entered into the MaxQ-10 software.

Two main categories of individual barriers emerged from data analysis. The first category included false wrong peace of mind after vaccination, lack of belief in the effectiveness of the vaccine, fear of the vaccine and its side effects, infection with the coronavirus, a tendency to show the insignificance of the disease, and exacerbation of the symptoms of COVID-19 in the case of vaccination. The other individual barriers were the contraction of COVID-19 in the case of vaccination and beliefs in more effects of preventive methods as compared to vaccination. The second category contained collective barriers such as not having proper information regarding the media, considering the political nature of vaccination, waiting for access to vaccines made in Iran, and preventing the family from vaccination.

Based on the results of this study, to increase the acceptance of COVID-19 vaccination, there is a need to remove internal and external barriers through various methods such as providing the community with accurate and timely information through the mass media and facilitating people’s access to various vaccines, especially Iran-made vaccine.

Cardiovascular diseases are the primary cause of death all around the world, and the complications of heart disease can reduce the patient's quality of life.Adherence to a therapeutic plan can reduce surgical complications and promote the healing process. This study aimed to survey the relationship between adherence to a therapeutic plan and quality of life in discharged patients after a coronary artery bypass graft (CABG). Descriptive correlational research was carried out to discover relationships among variables. The study was conducted in Hamadan hospital in 2014. Seventyone patients undergoing CABG surgery were selected by convenience sampling method. Before discharge, the patients completed the Mac New Quality of Life Questionnaire and adherence to therapeutic plan questionnaire that included medicine adherence, recommended care, diet and exercise orders, and incentive spirometry. After five weeks, patients again completed the questionnaires, and the data were analyzed. There was a positive and significant relationship  between patients' quality of life and adherence to the treatment plan. As the treatment program increased, the patients' quality of life also increased (r= 0.695, p <0.05). More adherence to treatment plans in patients undergoing CABG surgery leads to the enhancement of the quality of life in patients.

Trauma is one of the most important causes of death in. Therefore, proper management and treatment of these patients can be very beneficial. Therefore, the aim of this literature was to investigate the extent, scope and nature of researches on the effect of insulin therapy on the treatment efficacy of traumatic patients.

This study is a scoping review of research that was conducted by searching in Scopus, PubMed, Embase and ScienceDirect databases with keywords related to insulin therapy and trauma. In this study, all reports with human and animals as well as cohort and clinical trial studies were reviewed.

Of the 4365 studies, 73 studies met the inclusion criteria and were evaluated, most studies examining the effect of insulin on traumatic brain injury and immune system and the fewest were in trunk trauma patients, especially chest trauma. The findings of this study showed the effect of insulin therapy on decreasing levels of IL-6, IL-8, IL-10 and TNF-α thus decreasing the inflammatory response in trauma patients. Insulin therapy can reduce the risk of infection in patients with trauma and burns thereby reducing the number of days spent in intensive care units and dependence on ventilation.

Insulin therapy can be useful in treating trauma patients but increases the rate of hypoglycemic episodes that require careful monitoring of patients’ blood glucose which can have a negative impact on treatment outcomes.

 Since one of the most important methods of preventing the transmission of COVID-19 is wearing a mask, the present research was conducted to clarify the reasons for avoiding wearing a face mask by some people during the coronavirus outbreak.

 This is a qualitative content analysis study. In this study, 45 people from the cities of Evaz, Lar, and Gerash participated and were interviewed. The interview method was semi-structured, and the participants were selected based on purposive sampling. The collected data were analyzed by the conventional approach of the qualitative study.

 The participants of this study consisted of 45 individuals. The mean age of the samples was 41.89±12.88 years. A total of 30 themes were extracted during the qualitative content analysis and then divided into 6 categories, including personal, social, cultural, environmental, economic, and physical factors.

 According to the findings of this study, the factors influencing the lack of tendency to wear masks by people in the COVID-19 epidemic period are numerous and interact with each other. Therefore, for encouraging people to perform such protective behavior during the coronavirus epidemic, it is necessary to consider individual, social, environmental, economic, and physical factors together.

Since psychological well-being can predict the individuals’ suicidal ideation, therapeutic interventions such as reminiscence can be helpful for these persons. This study aimed to evaluate the effectiveness of reminiscence intervention on psychological well-being among individuals with a history of suicide attempt. This study was a randomized controlled trial. The population of this study consisted of individuals who had attempted suicide and referred to public hospitals in Shiraz. The sample size in each control and experimental group was estimated to be 20 people. The comparison of the mean score of depression in the intervention and control groups showed that the two groups did not have a significant difference before the intervention (P=0.414), while immediately after the intervention (P<0.001) and one month after it (P=0.003) a significant difference was observed. Also, the mean score of anxiety immediately after the intervention and one month after the intervention was significantly different between the intervention and control groups (P<0.05). In the stage immediately after the intervention, the comparison of the mean scores of self-esteem in the intervention and control groups showed a significant relationship (P=0.019). It can be said that this intervention has been effective in reducing the symptoms of anxiety and depression and increasing the self-esteem of people who have a history of attempted suicide.

Considering the problems, multiple diseases, disabilities, and the increased likelihood of suicidal ideation aroused by mental disorders among the elderly, the present study aimed to study the effects of reminiscence on depression in elderly people with suicidal ideation living in a nursing home.

This is a clinical trial study. Considering the inclusion criteria, 30 elderly persons were selected regarding the inclusion criteria and then assigned to two intervention (n = 15) and control (n = 15) groups using the simple random method. An educational program on reminiscence protocol was held in eight sessions. The participants were asked to complete the suicidal ideation, depression, and mental status questionnaires before, immediately after, and one month after the intervention. chi-squared, Mann-Whitney, and Friedman tests were used to analyze the data with SPSS software version 25.

The experimental and control groups were homogenous in terms of marital status, age, gender, psychological status, suicidal ideation, and level of education (P > 0.05). Comparison of the mean scores of depression showed a significant difference between the experimental and control groups immediately after (P = 0.037) and one month after the intervention (P = 0.030). However, before the intervention, no significant difference was observed between the two groups (P = 0.899)

According to the findings of this study, reminiscence as a nursing intervention can improve depression in the elderly with suicidal ideation. Accordingly, holding group reminiscing sessions in places such as nursing homes can be effective in reducing depression symptoms and preventing suicidal ideation in the elderly.

One of the treatments for depression and anxiety which has significantly increased in recent years in most countries is drinking lavender and chamomile herbal tea. The current study aimed to compare the result of these two types of herbal drinks on anxiety and depression in the postmenopausal women.

The present study is a randomized clinical trial conducted in 2020. It was recorded with the code of IRCT20090304001742N6 in the Iranian Registry of Clinical Trials. The total sample size was 96 people. In the current study, the depression questionnaire (created by Beck) and anxiety questionnaire (created by Spielberger) were used to assess the contributors. Each intervention group received 2 g of dried lavender and chamomile leaves, which were cooked twice daily—once in the morning and once at night—in 300 ml of boiling water for 10 to 15 minutes—as part of the intervention. The data were analyzed using one-way ANOVA, paired t-tests, and chi-square.

The average score of depression in the lavender tea group was reduced from 21.00±4.10 to 18.56±3.24 (P<0.001). In the group which consumed chamomile herbal tea, the average score of depression in the pre-intervention stage was 22.00±3.97, while after consuming chamomile herbal tea, it decreased to 18.31±3.05 (P<0.001). The mean score of depression among the groups that used lavender and the control group showed a significant difference. Although there was a non-significant difference between the average anxiety (state and trait) scores in the control group at the start and end of the study (P=0.058, P=0.083), there was a significant difference between the mean anxiety (state and trait) scores in the intervention groups before and after the intervention (P<0.001). Furthermore, the average score of depression between the group that used lavender and the control group displayed a significant difference (P=0.021).

In general, drinking lavender or chamomile herbal tea could alleviate the level of anxiety and depression in postmenopausal women.

The news of several people being affected by unusual pneumonia at the beginning of the year 2020 in China led to the introduction of a new type of coronavirus as the cause of a new respiratory disease. With the rapid spread of the disease in China and then to other parts of the world, the new coronavirus became scientifically known as severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and the resulting disease as coronavirus disease 2019 (COVID-19). This disease has a variety of symptoms and can cause SARS.

This study aimed to investigate the chronic diseases affecting the mortality rate of this disease.

This retrospective cohort study was performed on 7222 eligible patients admitted to hospitals in Sirjan, Iran, from March 2020 to June 2021 with a positive polymerase chain reaction for COVID-19. The researcher extracted information from the patients’ files using the questionnaire of demographic characteristics, clinical signs and symptoms, and the history of underlying diseases. The data were analyzed by the SPSS software using descriptive and analytical statistical tests, namely chi-squared, independent samples t-test, and univariate and multivariate logistic regression tests.

Out of 7,222 patients with COVID-19, 294 died, of whom 152 weremale and 142 were female (OR = 1.23, CI: 0.97 - 1.55). Moreover, 220 people out of 294 dead cases were over 60 years old (OR = 8.92, CI: 6.82 - 11.67). The most common diseases were hypertension (OR = 3.63, CI: 2.81 - 4.69) and diabetes (OR = 3.16, CI: 2.38 - 4.20). The most common symptoms among those who died were respiratory distress (51.4%) and cough (34.7%).

Themortality rate is directly related to the underlying diseases in COVID-19, and themost common underlying disease in the statistical population of this study was hypertension. In addition, respiratory distress is a common symptom in dead patients, which can be used as a predictor of death.

Different dimensions of nursing care as a component of health care services are very important in satisfying the patient. This study was conducted to investigate the patients satisfaction with nursing services in Imam Reza hospital of Lar City during the Covid-19 pandemic.

In this descriptive study conducted in 2020, 190 hospitalized patients were selected by convenience sampling. Data were collected using a standard patient satisfaction questionnaire by interview. Pearson’s and Spearmen’s correlation coefficient tests and one-way analysis of variance were used to determine the relationship between the variables.

The mean and standard deviation of patients 39; age was 47.63±14.58 years. Out of 190 respondents (patients), 110 were men (58%) and 80 were women (42%). Also, 63 people (33.2%) had undergraduate education, 28 (14.7%) had a diploma, 19 (10.0%) had an associate degree, 48 (25.3%) had a bachelor’s degree, and 32 (16.8%) had a master's degree. 24 people (12.6%) were dissatisfied with their opinion on the components of satisfaction, 49 (25.8%) were somewhat satisfied, and 111 (58.4%) were completely satisfied with their opinion on these components.

The findings of this study showed that the majority of patients had full satisfaction with nursing services. It is recommended to improve the quality of nursing care by implementing educational programs and assessing the reasons for patient dissatisfaction to increase patient satisfaction.

Work-related musculoskeletal injuries and complaints are widespread. Medical staff are exposed to these injuries depending on their duties.

This study aimed to investigate the occupational musculoskeletal complaints and related risk factors among medical staff working in Emam-Reza hospital of Larestan.

Following a cross-sectional, descriptive-analytical design, this study was performed on 124 medical staff working in Emam-Reza hospital of Larestan city in 2021. Participants were selected using convenient sampling. Data collection was performed using questionnaires filled out by participants from August to October 2021. The questionnaires were divided into demographic and musculoskeletal complaints using the Nordic questionnaire. Data analysis was administered using SPSS version 25. Statistical significance was considered when P-value < 0.05.

Of 124 participants, 92 (74.2%) were women. The mean age of participants was 34.97 ± 7.51 years. Most of the musculoskeletal complaints were related to the lumbar region, followed by one or both knees, and neck in the last 12 months and 7 days, respectively. Musculoskeletal complaints in the back during the previous 12 months and lumbar complaints during the previous 12 months and 7 days were significantly higher among nurses than others (P < 0.05). Also, in all body parts, the prevalence of musculoskeletal disorders was significantly higher in women than men (P < 0.05).

Given the musculoskeletal complaints among female nurses participating in this study, the authors recommend training them to prevent and focus attention on appropriate conditions and improving working conditions.

Adolescence can be a critical period during which individuals begin to cope with self-harm behaviors, and the increasing prevalence of suicide and suicidal attempts in this period is quite tangible in different communities. Given the lack of awareness concerning tolerance strategies in individuals with suicidal behavior, we investigated coping strategies in adolescents with suicidal thoughts.

This qualitative research was conducted during January and February 2019 in which we used the method of qualitative content analysis. In this study, 17 adolescents with suicidal ideation referred to Larestan welfare centers, Fars province were interviewed. In addition, one psychologist and 17 parents of the adolescents participated in this research. Purposeful sampling was done. Data collection continued through semi-structured deep interviews until data saturation.

Two main themes, namely effective coping strategies with 16 sub-themes and ineffective coping strategies with 12 subthemes were extracted from the data.

It was concluded that using appropriate plans to strengthen positive strategies in adolescents, providing them with new positive strategies, and omitting negative strategies can be conducive to preventing suicidal thoughts.

There are still conflicting results on thepostoperative consequences of patients with hip and femoralfractures based on the type of anesthesia. The aim of this studywas to compare mortality and morbidity of general and spinalanesthesia in patients undergoing hip and femoral fractures.

In this analytical cross-sectional study, the informationof 93 patients who had undergone hip and femoral surgery withgeneral and spinal anesthesia was studied during 2011-2019 inthe medical records by census method. Data were analyzed usingSPSS 23 software and descriptive and analytical statistics.

The general anesthesia group consisted of 29 patientsand the spinal anesthesia group included 64 patients. The twogroups were the same in terms of demographic information,preoperative hemodynamic variables, and previous medicalhistory. The results of the independent t-test with a significancelevel of 5% did not show a significant difference between thetwo groups in the following variables: mean duration of surgeryand duration of anesthesia, mean arterial pressure and heartrate after surgery, changes in blood pressure, and heart rateduring surgery, bleeding, intravenous fluids and blood productsintake, postoperative hemoglobin, number of days hospitalizedin the Intensive Care Unit and surgical ward. The mean postoperative mean arterial pressure score in the general anesthesiagroup was significantly higher than the spinal group (P=0.004).Complications and mortality after surgery did not differ betweenthe two types of anesthesia.

In general, these two methods of anesthesia do notdiffer from each other in terms of postoperative complications andmortality, and physicians can choose the appropriate anesthesiamethod according to the specific conditions of the patients

Today, with the increasing prevalence of COVID-19 in the world, the general population with excessive worry due to media reports has a higher level of psychological distress. Therefore, the present study aimed to determine the state of anxiety among Instagram users in 2020. 

This is a cross-sectional study that was conducted from June to July 2020 on 313 Instagram users. Coronavirus Anxiety Scale was used to measure anxiety caused by coronavirus in Iran. The subjects entered the study by availability sampling and filled out the questionnaire through the features of Instagram such as posts and stories. Chi-square test was used to analyze the relationship between independent and dependent variables according to the nature of the variable. The significance level was considered to be P < 0.05. 

Out of 313 participants in the study, 218 (69.6%) were in the age range of 19-35 years. Additionally, 50.5% of them were male and the majority of the participants had academic education. Overall, 21.4% of the participants had moderate to severe anxiety. There was no significant relationship between the participants’ levels of anxiety and demographic variables (age groups, gender, and level of education) (P > 0.05). 

The results of chi-square test showed that no significant relationship was observed between the dimensions of anxiety based on the demographic characteristics of individuals such as age groups (P=0.256), gender (P=0.644), and level of education (P=0.415).

Coronavirus disease 2019 (COVID-19) is a severe respiratory illness with an unknown cause that was diagnosed in December 2019 in Wuhan, China (1-3). Iran is one of the countries involved with this disease. The global outbreak of the disease raises concerns about increased anxiety due to the risk of contracting the virus (4). Therefore, in addition to causing physical harm, COVID-19 also has a serious effect on people's mental health. To date, no exact information is available on the mental health problems and psychological effects of COVID-19 on people, nor is it clear how people react when faced with such a crisis; therefore, for health care providers how best to respond to challenges related to COVID-19 is confusing. However, observing the consequences of mental health and the measures taken during the outbreak of SARS in 2003 can help the health care systems to make mental health interventions for people that are involved with COVID-19 (5). However, many people may not be sure that their health care systems are ready to deal with coronavirus, and a lack of trust in the country's health care system is likely to raise concerns about the consequences of the disease. In such circumstances, people use different methods of obtaining information when faced with crisis situations; sometimes these methods are invalid. One of these methods is to obtain information from invalid social media such as Instagram, WhatsApp and so on. Nowadays, with the availability of smartphones, the expansion of activities in virtual networks has become more and more. Therefore, people in anxious situations are looking for information to relieve their anxiety and for this purpose, they search social networks and being exposed to incorrect information in social networks can aggravate their anxiety (6). Therefore, in this situation, several factors may lead to development of Chronophobia. One of these conditions is using unreliable social media. In this regard, a study conducted by the Indian people on awareness, attitude and anxiety about COVID-19 showed that people's anxiety about this disease was at a high level and distress-related social media was seen in 36.4% of the people, and the participants expressed that one of the most important resources of anxiety was the social media (7). At this time, the important question is whether the health care systems in the country are ready to deal with the growing concern of the people in such a situation that is the result of misinterpretation of the symptoms of COVID-19 and in cases where mild respiratory symptoms may develop Chronophobia. Meanwhile, the role of health care provider in reducing people's anxiety and preventing Chronophobia is vital (8, 9). Finally, it can be said that health care systems can prevent Chronophobia by increasing people's knowledge, thus improving their attitudes towards COVID-19.

In the last two decades, the number of people who have referred to mental health services due to concerns about gender identity has increased dramatically. The aim of this study was to present the most important and fundamental results of studies on transgender psychological and behavioral disordersand compare these results.

This is a narrative review study. Search for articles related to common psychological and behavioral disorders in transgender people was done by two trained researchers between December 2019 and March 2020 in 5 Latin scientific databases (Google Scholar, PubMed / Medline, Scopus, ISI Web of Science and Embase).

Psychological and behavioral disorders were much higher in transgender people than in the general population. The most common disorders included anxiety and depression, suicidal attempt, drug abuse, self-injury without suicidal tendency, and HIV.

Transgender people are constantly harassed and abused by friends, acquaintances, classmates and teachers, and even their families. Having multiple sexual partners increases the risk of HIV infection and other sexual misconduct. Therefore, governments need to implement their support programs through training centers and counseling for transgender individuals.