THE COMPARISON OF SUICIDAL THOUGHTS, DEPRESSION, ANXIETY, AND STRESS AMONG ADOLESCENT SUICIDE ATTEMPTERS ABUSING DRUG AND ADOLESCENTS WITHOUT DRUG ABUSE IN ZABOL, 2016

Addiction and drug abuse are among the issues that have been greatly adverted by the clinical psychologists and psychiatrists. Suicide attempt, like other social phenomena, is not uni-causal; a variety of factors affects this phenomenon. Thus, having an exact awareness of suicide factors and studying the importance of the factors seem necessary. The present research aims at studying suicidal thoughts, depression, anxiety, and stress among adolescent suicide attempters abusing drug and adolescents without any drug abuse in Zabol in 2016. The present study is a comparative descriptive-analytical one. The statistical populations of the present study were all the 18-to-29-year-old suicide attempters, with a record of drug abuse referring to Imam Ali Hospital in Zabol in 2016. The data collection tool was depression questionnaire and Beck's suicidal thoughts questionnaire. T-independent and chi-square tests were used for data analysis applying SPSS version 18. The participants' mean age was 14.12 +/- 4.13 years. The drug abusers' mean score of depression, anxiety, stress, and suicidal thoughts were 10.12 +/- 4.16, 7.26 +/- 4.48, 9.02 +/- 4.15, and 18.42 +/- 6.12 respectively. As for the comparison group they were 4.32 +/- 2.18, 4.36 +/- 4.26, 5.16 +/- 4.46, and 6.32 +/- 4.18 respectively (p=0.001). The findings obtained from the T-test for the independent groups indicate the difference in means between the two groups with respect to the degree of depression (p=0.001) and suicidal thoughts (p=0.002). The findings obtained from the present study indicated that variables such as drug abuse, depression, anxiety, and suicidal thoughts are closely related with suicide attempt. Given the comorbidity of drug dependence and other psychiatric disorders, providing educational interventions, executing preventive social plans, and treating psychological disorders for preventing suicide attempts are of great importance

Comparison of Intraoperative and Early Postoperative Outcomes of Caudal Versus Dorsal Penile Nerve Blocks for Outpatient Penile Surgeries

Objective To compare intraoperative and 1-hour postoperative outcomes in caudal versus dorsal penile nerve block (DPNB) patients undergoing penile surgeries. Material and Methods We performed a retrospective cohort study of males 3. Secondary outcomes were intraoperative/post-anesthesia care unit (PACU) narcotics, pre-incision anesthesia time, adjusted operating room charges and complications. We performed bivariate and multivariable analyses controlling for demographic/procedure characteristics and clustering by surgeon. Results Of 738 patients, (mean age 2.1 years) 74.1% had a caudal. DPNB patients were more likely to have a maximum pain score >3 (19.5% vs. 8.1%, p 3 (95% CI 1.7- 4.4, p<0.0001) and 5.2 times the odds of intraoperative/PACU narcotic administration (95% CI 3.3-8.1, p<0.0001). In multivariable analyses, caudal patients had longer pre-incision anesthesia time (27.9 ± 7.4 vs. 19.5 ± 6.6 minutes, p<0.0001) and higher adjusted operating room charges ($12,760 ± 4077 vs.$9,402 ± 3741, p=0.01). Conclusion Caudal blocks may offer a small advantage in the immediate postoperative period although cost-effectiveness is unproven

Phytochemistry and insecticidal effect of different parts of Melissa officinalis on Tetranychus urticae

Background and objectives: In recent years, biological control of parasites by essential oils (EOs) derived from plants is one of the alternatives to synthetic pesticides.Melissa officinalis from Lamiaceae family is distributed in many parts of Iran. It is known as an excellent source of antioxidants, antibacterial, antiviral and antifungal constituents. The present study investigated the insecticide properties of M. officinalis against Tetranychus urticae tick. Methods: The EO of different parts of plant was extracted and analyzed by gas chromatography and mass spectrometry (GC/MS). The ticks were placed on the filter paper in the bottom of a petri dish (9 mm), and contact toxicity assay was then performed by contacting the extract with the ticks. Results: The EO of leaves showed the most potent insecticidal effect while the stem EO demonstrated the weakest effect. The lowest concentration of EO from the leaves showed more considerable insecticide activity compared to the highest concentration of stem and flower EOs. Conclusion: Melissa officinalis is an effective insecticide with potent effect against T. urticae and it could be suggested as a natural pesticide against T. urticae

Diagnostic accuracy of the Abbott ID NOW SARS-CoV-2 rapid test for the triage of acute medical admissions

Background: Decisions to isolate patients at risk of having coronavirus disease 2019 (COVID-19) in the emergency department (ED) must be rapid and accurate to ensure prompt treatment and maintain patient flow whilst minimising nosocomial spread. Reverse transcription polymerase chain reaction (RT-PCR) assays are too slow to achieve this, and near-patient testing is being used increasingly to facilitate triage. The ID NOW severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) assay is an isothermal nucleic acid amplification near-patient test which targets the RNA-dependent RNA-polymerase gene. Aim: To assess the diagnostic performance of ID NOW as a COVID-19 triage tool for medical admissions from the ED of a large acute hospital. Methods: All adult acute medical admissions from the ED between 31st March and 31st July 2021 with valid ID NOW and RT-PCR results were included. The diagnostic accuracy of ID NOW [sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV)] was calculated against the laboratory reference standard. Discrepant results were explored further using cycle threshold values and clinical data. Findings: Two percent (124/6050) of medical admissions were SARS-CoV-2 positive on RT-PCR. Compared with PCR, ID NOW had sensitivity and specificity of 83.1% [95% confidence interval (CI) 75.4–88.7] and 99.5% (95% CI 99.3–99.6), respectively. PPV and NPV were 76.9% (95% CI 69.0–83.2) and 99.6% (95% CI 99.5–99.8), respectively. The median time from arrival in the ED to ID NOW result was 59 min. Conclusion: ID NOW provides a rapid and reliable adjunct for the safe triage of patients with COVID-19, and can work effectively when integrated into an ED triage algorithm

Effect of vitamin D vaginal suppository on sexual functioning among postmenopausal women: a three-arm randomized controlled clinical trial

Objective: Vaginal atrophy, the second most common complication of menopause, can lead to sexual dysfunction. This study evaluated the effect of a vitamin D vaginal suppository on sexual functioning in postmenopausal women. Methods:This three-arm randomized controlled trial was conducted between August 2019 and August 2020. The sample comprised 105 postmenopausal women who were referred to comprehensive health service centers to receive postmenopausal care. The inclusion criteria were as follows: (i) being menopausal for at least 1 year, (ii) being married, (iii) being sexually active, and (iv) having sexual desire. Participants were randomly assigned to three groups for 8 weeks of treatment: intervention (vaginal suppository containing 1,000 units of vitamin D3), placebo (vaginal suppository placebo), or control (no treatment). The main outcome measure was sexual functioning, which was assessed using the Female Sexual Function Scale (FSFI) 4 times during the study (i.e., 1 month before the intervention, immediately after the intervention, 1 month after the intervention, and 2 months after the intervention). Results: Immediately and 1 month after the trial, the intervention group had the highest FSFI score, followed by the placebo group, both of which were significantly higher than those of the control group (P<0.05). At the 2-month follow-up, the intervention and placebo groups had similar FSFI scores (P=0.08), both of which were significantly higher than those in the control group (P=0.001 and P=0.03, respectively). Conclusion: Vitamin D vaginal suppositories were more effective at improving sexual functioning among postmenopausal women in the short-term and appeared to prevent aging-related sexual functioning decline in the long term

The role of hospital service quality in developing the satisfaction of the patients and hospital performance

This paper aimed to examine a conceptual model for the relationships between hospital service quality, patient satisfaction, hospital utilization, and hospital financial performance. A total of 176 hospitals was selected from California State for this study. The standardized performance measures were used together with precisely defined specifications and standardized data collection protocols. First, an exploratory factor analysis with Varimax rotation was performed. The measurement prop-erties were then assessed in a confirmatory factor analysis (CFA). The analysis results show that quality had a significant effect on satisfaction, which, in turn, affected the financial performance. The results provide support for the previous findings indicated that service quality was positively associated with patient satisfaction and that satisfaction and utilization had a significant positive effect on financial performance. The analysis results provide support for the previous findings that hospital service quality is positively related to patient satisfaction. The findings also show that patient satisfaction and hospital utilization have a significant positive effect on hospital financial performance

'Treatment of the Sportsman's groin': British Hernia Society's 2014 position statement based on the Manchester Consensus Conference

&lt;b&gt;Introduction&lt;/b&gt; The aim was to produce a multidisciplinary consensus to determine the current position on the nomenclature, definition, diagnosis, imaging modalities and management of Sportsman's groin (SG).&lt;p&gt;&lt;/p&gt; &lt;b&gt;Methods&lt;/b&gt; Experts in the diagnosis and management of SG were invited to participate in a consensus conference held by the British Hernia Society in Manchester, UK on 11–12 October 2012. Experts included a physiotherapist, a musculoskeletal radiologist and surgeons with a proven track record of expertise in this field. Presentations detailing scientific as well as outcome data from their own experiences were given. Records were made of the presentations with specific areas debated openly.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Results&lt;/b&gt; The term ‘inguinal disruption’ (ID) was agreed as the preferred nomenclature with the term ‘Sportsman's hernia’ or ‘groin’ rejected, as no true hernia exists. There was an overwhelming agreement of opinion that there was abnormal tension in the groin, particularly around the inguinal ligament attachment. Other common findings included the possibility of external oblique disruption with consequent small tears noted as well as some oedema of the tissues. A multidisciplinary approach with tailored physiotherapy as the initial treatment was recommended with any surgery involving releasing the tension in the inguinal canal by various techniques and reinforcing it with a mesh or suture repair. A national registry should be developed for all athletes undergoing surgery.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusions&lt;/b&gt; ID is a common condition where no true hernia exists. It should be managed through a multidisciplinary approach to ensure consistent standards and outcomes are achieved

Laparoscopic correction of perforated peptic ulcer: first choice? A review of literature

Background Perforated peptic ulcer (PPU), despite antiulcer medication and Helicobacter eradication, is still the most common indication for emergency gastric surgery associated with high morbidity and mortality. Outcome might be improved by performing this procedure laparoscopically, but there is no consensus on whether the benefits of laparoscopic closure of perforated peptic ulcer outweigh the disadvantages such as prolonged surgery time and greater expense. Methods An electronic literature search was done by using PubMed and EMBASE databases. Relevant papers written between January 1989 and May 2009 were selected and scored according to Effective Public Health Practice Project guidelines. Results Data were extracted from 56 papers, as summarized in Tables 1-7. The overall conversion rate for laparoscopic correction of perforated peptic ulcer was 12.4%, with main reason for conversion being the diameter of perforation. Patients presenting with PPU were predominantly men (79%), with an average age of 48 years. Onethird had a history of peptic ulcer disease, and one-fifth took nonsteroidal anti-inflammatory drugs (NSAIDs). Only 7% presented with shock at admission. There seems to be no consensus on the perfect setup for surgery and/or operating technique. In the laparoscopic groups, operating time was significant longer and incidence of recurrent leakage at the repair site was higher. Nonetheless there was significant less postoperative pain, lower morbidity, less mortality, and shorter hospital stay. Conclusion There are good arguments that laparoscopic correction of PPU should be first treatment of choice. A Boey score of 3, age over 70 years, and symptoms persisting longer than 24 h are associated with higher morbidity and mortality and should be considered contraindications for laparoscopic intervention