Prevalence and Risk Factors of Voice Disorders in University Teaching Faculty Members: A Pilot Study

Voice disorder is a multifactorial impairment. Several studies have shown that there is a direct relationship between voice problems and voice-related jobs. Therefore, professional voice users, including teachers, are at high risk of voice disorders, which threatens the employment positions. Also, the investigation of voice impairments among faculty members seems essential. The purpose of this study is to assess the prevalence of voice disorders in faculty members, its impact on the physical, emotional, and functional status of this job group, with and without voice disorders, and the correlation of voice disorders with some risk factors. Methods The participants of this study were 114 university teaching faculty members of Mashhad University of Medical Sciences, with a mean age of 43.95±0.98 years. The current cross-sectional descriptive-analytical study used a demographic questionnaire and Voice Handicap Index (VHI) as the data collection instruments. In the present study, based on VHI test results, participants with a total VHI score greater than 14.5 are considered to have voice disorders. Results The prevalence of voice disorders among university teaching faculty members was 27.19%. There was a significant correlation between allergy and voice disorders (P= 0.04). Significant differences were also found between the two study groups in terms of the total score of the VHI and its subscales (P <0.001). Conclusions Considering the 27.19% prevalence of voice disorders among university teaching faculty members and its effect on the total VHI score, our results confirm that education, prevention, and treatment programs are critical to lessen the frequency of voice disorders related to teaching. However, it has been found that this job group with voice disorders is four times more likely to have allergies than those without voice disorder, which indicates the importance of controlling this problem

COVID‑19 associated rhino‑orbito‑cerebral mucormycosis, risk factors and outcome predictors; a multicentric study

Background Since the onset of the Covid-19 pandemic, an increase in mucormycosis cases has been observed in many countries, including Iran. However, the role of covid-19 and associated risk factors have not been thoroughly investigated. Objective This study is designed to identify epidemiologic characteristics, risk factors, and outcome predictors of Covid-19-Associated Rhino-Orbito-Cerebral Mucormycosis (C-ROCM). Methods Data of pathology proven Covid Associated ROCM cases were retrospectively obtained from 7 tertiary care centers throughout Iran from February 20, 2021, to July 22, 2021. Univariate and multivariate analyses were performed using binary logistic regression to assess the effects of various factors on the outcome. Results A total of 132 patients with C-ROCM were included in the study. The mean age of patients was 61.6 ± 13.9 (60.6% male). In 12 patients (9.1%), both eyes were involved. Diabetes was the mostcommon comorbidity (94.7%). The mortality rate was 9.1%, higher in males (12.5%) than females (3.8%). Severe vision impairment was seen in 58 patients (43.9%). Main factors that had a negative impact on the outcome in the univariate analysis include older age (P < 0.001), higher steroid dosage (P < 0.001), higher HbA1c level (P < 0.001), Covid-19 severity (P < 0.001), and brain involvement (P < 0.001). However, in the multivariate analysis, the effects of age (P = 0.062), steroid dosage (P = 0.226), and Covid- 19 intensity (P = 0.084) decreased, and the difference was no longer statistically significant. CRAO was a predictor of mortality in the univariate analysis (P = 0.008, OR = 4.50), but in the multivariate analysis, this effect decreased and was no longer significant (P = 0.125). Conclusion The risk of C-ROCM and its complications may increase in patients with more severe Covid-19, steroid over-prescription, ICU admission due to Covid-19, and poor glycemic control during and after Covid-19 treatment

Characteristics of carpal tunnel syndrome in patients with cervical radiculopathy: A cross‐sectional study

Abstract Background and Aims Cervical radiculopathy (CR) is a group of signs and symptoms caused by cervical root dysfunction. Patients with this condition may also have carpal tunnel syndrome (CTS), which is caused by compression of the median nerve in the carpal tunnel. This coexistent condition is referred to as double crush syndrome (DCS) which is explained by proximal disruption in axoplasmic flow that may result in nerve dysfunction. Yet, the accuracy of this hypothesis remains controversial. Materials and Methods Patients with confirmed CR according to electromyography were included in this retrospective study. However, we omitted patients with overt diabetic neuropathy, prior spinal or hand surgery and/or fractures, and rheumatoid arthritis. Patients underwent electrodiagnostic studies, and the results were used to determine CTS severity. We used Pearson's χ2 test to assess the correlation between the severity of CTS and CR. Descriptive analysis was used to report patient characteristics and the prevalence of CTS in CR patients. Results We included 291 participants, 59% of whom were women. Although insignificant, DCS was observed more in women (n = 110) compared to men (n = 71). However, we found that patients with DCS (54.81 ± 13.3) were older than non‐DCS patients (43.71 ± 12.94) which was statistically significant (p  0.05). In total, CTS was observed in 62.2% (n = 181) patients. Conclusion In summary, we found a relatively high prevalence of DCS in the present study. In patients with and without DCS, gender did not seem to play a role but the growing age seemed to contribute to DCS. The severity of CTS was not related to CR severity at any cervical level, which negates a causal relation between the pre‐existing CR and newly diagnosed CTS

Direct Observation of Procedural Skills for the Clinical Evaluation of Speech Therapy Students in the Assessment of Speech Organs

Background and Objectives: Direct observation of procedural skills (DOPS) is one of the new methods of clinical evaluation that gives feedback about students’ clinical skills. The design and psychometrics of the DOPS test tool for the clinical assessments of speech therapy students in the evaluation of speech organs have been discussed. Methods: In the current non-interventional descriptive study, 20 speech therapy students were selected from the Faculty of Rehabilitation Sciences. The DOPS test related to the speech organs evaluation procedure and its evaluation checklist was prepared. After obtaining the consent and training, students and evaluators entered the study. The evaluators observed each student’s work with a real patient, and their judgments were recorded based on a structured checklist. Each of them was given feedback in the appropriate environment. Face validity, content, and inter-rater reliability were measured and reported. Results: Face validity, including importance, clarity, and simplicity, was investigated for each item. The items’ impact scores for favorable face validity of >1.5 were included in the questionnaire. The content validity index for each item was over 0.8, and the content validity ratio was >0.62. All students have chosen the option of slightly satisfied to completely satisfied, and 70% have chosen the option of high satisfaction and complete satisfaction. None of the evaluators chose the options of no satisfaction to slightly satisfied. For inter-rater reliability, the intraclass correlation coefficient (ICC) was calculated using the opinions of two evaluators, and the ICC value was 0.884 with a 95% confidence interval (0.708-0.954) (P<0.001). Conclusion: The results indicated good inter-rater agreement and reasonable reliability. According to this study, the use of DOPS to evaluate clinical skills in speech therapy students in evaluating speech organs has high validity and reliability

The Relationship Between Workplace Spirituality, Job Satisfaction and Attitude Toward Death Among the Staff of the Emergency Department

Background: The present study was carried out aimed to examine the relationship between workplace spirituality and job satisfaction. It also aimed to determine the intermediary role of attitude toward death among emergency department staff in Shiraz city. Materials and Methods: In this descriptive and correlation study, the statistical population included 90 staff of the Shiraz Emergency department who were selected through simple random sampling in 2016-2017. Spirituality questionnaires in the workplace, life satisfaction and attitude towards death were used in this research, and the data were analyzed by SPSS and EMOS software. Results: The results of the data analysis indicated that workplace spirituality had a negative effect (&beta;=-0.32, P=0.001) on neutral acceptance and a positive effect (&beta;=0.21, P=0.03) on active acceptance and life satisfaction (&beta;=0.19, P=0.05). Furthermore, out of the attitudes toward death scales, only neutral acceptance could play a mediating role between workplace spirituality and life satisfaction (&beta;=-0.27, P=0.00). Model fitting indicators show that the model has a good fit (X2=0.86, GFA=0.97, CFI=0.99). Conclusion: The results show that workplace spirituality is compatible with life satisfaction and the mediating role of attitude toward death among the staff of the emergency department

Zinc- and Copper-Doped Mesoporous Borate Bioactive Glasses: Promising Additives for Potential Use in Skin Wound Healing Applications

In this study, zinc (Zn)- and copper (Cu)-doped 13-93B3 borate mesoporous bioactive glasses (MBGs) were successfully synthesized using nitrate precursors in the presence of Pluronic P123. We benefited from computational approaches for predicting and confirming the experimental findings. The changes in the dynamic surface tension (SFT) of simulated body fluid (SBF) were investigated using the Du Noüy ring method to shed light on the mineralization process of hydroxyapatite (HAp) on the glass surface. The obtained MBGs were in a glassy state before incubation in SBF. The formation of an apatite-like layer on the SBF-incubated borate glasses was investigated by X-ray diffraction (XRD) and scanning electron microscopy (SEM). The incorporation of Zn and Cu into the basic composition of 13-93B3 glass led to changes in the glass transition temperature (Tg) (773 to 556 °C), particle size (373 to 64 nm), zeta potential (−12 to −26 mV), and specific surface area (SBET) (54 to 123 m2/g). Based on the K-means algorithm and chi-square automatic interaction detection (CHAID) tree, we found that the SFT of SBF is an important factor for the prediction and confirmation of the HAp mineralization process on the glasses. Furthermore, we proposed a simple calculation, based on SFT variation, to quantify the bioactivity of MBGs. The doped and dopant-free borate MBGs could enhance the proliferation of mouse fibroblast L929 cells at a concentration of 0.5 mg/mL. These glasses also induced very low hemolysis (Pseudomonas aeruginosa. In summary, we showed that Cu-/Zn-doped borate MBGs can be fabricated using a cost-effective method and also show promise for wound healing/skin tissue engineering applications, as especially supported by the cell test with fibroblasts, good compatibility with blood, and antibacterial properties

Injury burden in individuals aged 50 years or older in the Eastern Mediterranean region, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

Background: Injury poses a major threat to health and longevity in adults aged 50 years or older. The increased life expectancy in the Eastern Mediterranean region warrants a further understanding of the ageing population's inevitable changing health demands and challenges. We aimed to examine injury-related morbidity and mortality among adults aged 50 years or older in 22 Eastern Mediterranean countries. Methods: Drawing on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we categorised the population into adults aged 50–69 years and adults aged 70 years and older. We examined estimates for transport injuries, self-harm injuries, and unintentional injuries for both age groups, with sex differences reported, and analysed the percentage changes from 1990 to 2019. We reported injury-related mortality rates and disability-adjusted life-years (DALYs). The Socio-demographic Index (SDI) and the Healthcare Access and Quality (HAQ) Index were used to better understand the association of socioeconomic factors and health-care system performance, respectively, with injuries and health status in older people. Healthy life expectancy (HALE) was compared with injury-related deaths and DALYs and to the SDI and HAQ Index to understand the effect of injuries on healthy ageing. Finally, risk factors for injury deaths between 1990 and 2019 were assessed. 95% uncertainty intervals (UIs) are given for all estimates. Findings: Estimated injury mortality rates in the Eastern Mediterranean region exceeded the global rates in 2019, with higher injury mortality rates in males than in females for both age groups. Transport injuries were the leading cause of deaths in adults aged 50–69 years (43·0 [95% UI 31·0–51·8] per 100 000 population) and in adults aged 70 years or older (66·2 [52·5–75·5] per 100 000 population), closely followed by conflict and terrorism for both age groups (10·2 [9·3–11·3] deaths per 100 000 population for 50–69 years and 45·7 [41·5–50·3] deaths per 100 000 population for ≥70 years). The highest annual percentage change in mortality rates due to injury was observed in Afghanistan among people aged 70 years or older (400·4% increase; mortality rate 1109·7 [1017·7–1214·7] per 100 000 population). The leading cause of DALYs was transport injuries for people aged 50–69 years (1798·8 [1394·1–2116·0] per 100 000 population) and unintentional injuries for those aged 70 years or older (2013·2 [1682·2–2408·7] per 100 000 population). The estimates for HALE at 50 years and at 70 years in the Eastern Mediterranean region were lower than global estimates. Eastern Mediterranean countries with the lowest SDIs and HAQ Index values had high prevalence of injury DALYs and ranked the lowest for HALE at 50 years of age and HALE at 70 years. The leading injury mortality risk factors were occupational exposure in people aged 50–69 years and low bone mineral density in those aged 70 years or older. Interpretation: Injuries still pose a real threat to people aged 50 years or older living in the Eastern Mediterranean region, mainly due to transport and violence-related injuries. Dedicated efforts should be implemented to devise injury prevention strategies that are appropriate for older adults and cost-effective injury programmes tailored to the needs and resources of local health-care systems, and to curtail injury-associated risk and promote healthy ageing. Funding: Bill & Melinda Gates Foundation