STUDYING THE FACTORS AFFECTING SOCIAL PARTICIPATION IN OLDER WOMEN

The issue of social participation has an important role in social health promotion consisting a variety of individual and collective actions in order to determine the destiny of society and themselves and also effecting on decision-making processes regarding public affairs. Accordingly, this study aimed to study the factors related to the rate of social participation in older women. This is a cross-sectional study which after taking informed consent is conducted on 50 women retired from Fatemieh Hospital of Hamadan in census manner in 2015. Data collection tool included a questionnaire of demographic characteristics and factors related to social participation. Data were analyzed using SPSS version 21, descriptive statistics, chi-square test, pair t-test and one way analysis of variance. In this study, the significant level was considered less than 0.05. Experience and duration of social participation had significant relation with each other by overall assessment of factors related to participation. 54 had participated in health promotion programs in their living areas. There was a significant relation between the rate of social participation in health promotion and variable of time (p=0.013) and participation experience (p=0.005). Women retired from Fatemieh Hospital of Hamadan had an appropriate attitude in social participation for health promotion. However, for further increase of social participation, there should be training and facilitating through providing suitable facilities such as confidence-building, awareness of ways to communicate with administrators and welcoming of administrators from suggestions of people

Fear, Loss, Social Isolation, and Incomplete Grief Due to COVID-19: A Recipe for a Psychiatric Pandemic

The experience of the loss of the relatives, which is naturally one of the most stressful events in a person's life, has turned into a new concept and challenge for survivors and mental health professionals during the coronavirus era. We discussed how restrictions caused by social distancing potentially increase the likelihood of a phenomenon called complicated grief or prolonged bereavement disorder and multilayer response by case finding to increase the access to public education to manage this complicated situation. © 2020 Iran University of Medical Sciences. All rights reserved

Impact of immunosuppressive treatment on liver fibrosis in autoimmune hepatitis

The impact of treatment on progression of fibrosis in autoimmune hepatitis (AIH) is unknown. We assessed the changes in liver fibrosis before and after treatment among these patients. Nineteen AIH patients who had paired liver biopsies were studied. Of these, seven had been treated with 6 months of cyclosporine A and the rest with 6 months of prednisolone for induction of remission. Thereafter all had been maintained on azathioprine. Biopsy specimens before and after treatment were reviewed by one pathologist and scored by the Ishak method. Mean fibrosis stages before and after treatment were compared. Also, factors predicting significant fibrosis (stage �3) and cirrhosis (stage �5) at presentation were assessed. Mean interval between biopsies was 3.38 years. Mean fibrosis stage decreased from 4.53 to 2.16 following treatment (P < 0.001). Mean decrement in inflammatory grade was 8 scores (range, 4-10) in patients in whom fibrosis improved, and 2 scores (range, 0-4) in patients in whom fibrosis did not decrease after treatment (P < 0.001). ALT-to-platelet ratio was the best predictor of significant fibrosis and also cirrhosis. Fibrosis commonly improves after immunosuppressive treatment in AIH. ALT-to-platelet ratio can predict accurately the presence of significant fibrosis and cirrhosis in AIH. © 2005 Springer Science+Business Media, Inc

LHRH-A implantation on reproductive cycle of Iranian sturgeon

The Iranian sturgeon (Acipenser persicus) is one of most commercially important sturgeon species in the Caspian Sea and it is considered as an endemic sturgeon of the south part of the Caspian sea. Most of its populations distributed around the south coast of the sea and also the most Iranian caviar production belonged to this species. Due to overfishing, degradation of the rivers conditions as the natural reproduction places the stocks of the fish is decreasing and that is why the Islamic republic of Iran releases millions of its fingerlings to the rivers that end to the sea to stock restoration. With regard to the high expenses of the artificial propagation and fingerlings production, finding and creation of better output will play an important role to decrease the production expenditures. Now days, the decrease in the natural stocks of broodstocks and also the low quality and immature caught broodstocks are the fundamental problems which the industry of sturgeon mass production faces. These not fully matured brooders do not response the hormonal induction processes at the sturgeon hatcheries (because they do not reach to final maturation and some of them having polarization index greater than 10) and large numbers of the caught and transported brooders to the hatcheries will not produce any fry (as the data distributed and published by the sturgeon hatcheries about the production techniques). The main objective of the research study is to apply a new method for artificial reproduction (LHRH-A implantation) to gain the best output from the Iranian sturgeon brooders caught and transported from the Caspian Sea which will be done for the first time on sturgeons and there is not still any report of the application of this procedure (LHRH-A implantation) over these kinds of fishes. Most published report on the method belonged to the teleosts

Comparative study of the effect of warming at various temperatures on biochemical, hematologic, and hemodynamic parameters during spinal fusion surgery under intravenous anesthesia

Background: Perioperative inadvertent hypothermia (PIH) commonly occurs after major surgical procedures under local or general anesthesia and increases the risk of complications such as organ failure, hypoperfusion, and peripheral vasoconstriction, as well as adverse postoperative outcomes, such as wound infection and increased surgical bleeding. Objectives: We hypothesized that the intra-operative warming may affect these complications and thus, we aimed to compare the most appropriate temperature of the warmer to decrease patients� complications. Methods: The present randomized clinical trial investigated 90 patients undergoing total intravenous anesthesia in posterior spinal fusion surgery, randomly divided into two groups of 45. The warmer was set at 38°C for group �A� during surgery and at 40°C for group �B.� Patient�s demographic characteristics, the serum level of hemoglobin, hematocrit, and platelet counts, mean core temperature, systolic blood pressure (BP), heart rate, and respiratory rate were recorded before and after the surgery. Variables were compared between the two groups at three time intervals (during induction, during operation, and during recovery). Results: The mean temperature was not different between the two groups at the three time intervals. Other laboratory serum tests, vital signs, and oxygen consumption were maintained within the normal range although they did not improve significantly in two groups at the three time intervals. Conclusions: There was no significant difference in warming of the patients during operation at 38 or 40°C to prevent hypothermia-induced complications during induction, operation, and recovery. © 2018, Author(s)

Prospective Acid Reflux Study of Iran (PARSI): Methodology and study design

<p>Abstract</p> <p>Background</p> <p>Gastroesophageal reflux disease is a common and chronic disorder but long term, prospective studies of the fate of patients seeking medical advice are scarce. This is especially prominent when looking at non-erosive reflux disease (NERD) patients.</p> <p>Methods</p> <p>We designed a prospective cohort to assess the long term outcome of GERD patients referring to gastroenterologists. Consecutive consenting patients, 15 years of age and older, presenting with symptoms suggestive of GERD referring to our outpatient clinics undergo a 30 minute interview. Upper gastrointestinal endoscopy is performed for them with protocol biopsies and blood samples are drawn. Patients are then treated according to a set protocol and followed regularly either in person or by telephone for at least 10 years.</p> <p>Discussion</p> <p>Our data show that such a study is feasible and follow-ups, which are the main concern, can be done in a fairly reliable way to collect data. The results of this study will help to clarify the course of various subgroups of GERD patients after coming to medical attention and their response to treatment considering different variables. In addition, the basic symptoms and biological database will fuel further molecular epidemiologic studies.</p

Epidemiological characteristics of coronavirus disease 2019 (COVID-19) patients in IRAN: A single center study

Background: An outbreak of COVID-19 in Iran has spread throughout the country. Identifying the epidemiological characteristics of this disease will help to make appropriate decisions and thus control the epidemic. The aim of this study was characterization of the epidemiological features of COVID-19 in Iran. Methods: In this retrospective study, data related to the epidemiological characteristics of COVID-19 patients admitted to Baqiyatallah Hospital in Tehran, Iran, from 19 February 2020 to 15 April 2020 have been analyzed and reported. Patient characteristics including age, gender and underlying diseases were investigated. Data were collected through patient records. Sex ratio, Case Fatality Rate (CFR) and daily trend of cases were also determined. A multiple logistic regression analysis was also performed to assess affecting factors on mortality. Results: From February 19, 2020 to April 15, 2020, 12870 patients referred to the hospital emergency department, of which 2968 were hospitalized with COVID-19 diagnosis. The majority of cases were in the age group of 50 to 60 years of old. The male-to-female ratio was 1.93:1. A total of 239 deaths occurred among all cases for an overall CFR of 1.85 based on the total number of patients (both outpatient and inpatient) and 8.06 among hospitalized patients. Out of all patients 10.89 had comorbidity. Diabetes, chronic respiratory diseases, hypertension, cardiovascular diseases, chronic Kidney diseases and cancer were the most common comorbidities with 3.81, 2.02, 1.99, 1.25, 0.60 and 0.57 , respectively. Male gender (OR=1.45, 95 CI: 1.08-1.96), older age (OR=1.05, 95 CI: 1.04-1.06) and having underlying diseases (OR=1.53, 95 CI: 1.04-2.24) were significantly associated with mortality. Conclusions: The results of this study showed that Male gender, older age and having comorbidities were significantly associated with the risk of death among COVID-19 patients. It is important to pay special attention to male elderly patients with underlying diseases. © 2020 Elsevier B.V

Global, regional, and national burden of meningitis and its aetiologies, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we aimed to assess incident cases and deaths due to acute infectious meningitis by aetiology and age from 1990 to 2019, for 204 countries and territories. Methods: We modelled meningitis mortality using vital registration, verbal autopsy, sample-based vital registration, and mortality surveillance data. Meningitis morbidity was modelled with a Bayesian compartmental model, using data from the published literature identified by a systematic review, as well as surveillance data, inpatient hospital admissions, health insurance claims, and cause-specific meningitis mortality estimates. For aetiology estimation, data from multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature studies were analysed by use of a network analysis model to estimate the proportion of meningitis deaths and cases attributable to the following aetiologies: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, group B Streptococcus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Staphylococcus aureus, viruses, and a residual other pathogen category. Findings: In 2019, there were an estimated 236 000 deaths (95% uncertainty interval [UI] 204 000–277 000) and 2·51 million (2·11–2·99) incident cases due to meningitis globally. The burden was greatest in children younger than 5 years, with 112 000 deaths (87 400–145 000) and 1·28 million incident cases (0·947–1·71) in 2019. Age-standardised mortality rates decreased from 7·5 (6·6–8·4) per 100 000 population in 1990 to 3·3 (2·8–3·9) per 100 000 population in 2019. The highest proportion of total all-age meningitis deaths in 2019 was attributable to S pneumoniae (18·1% [17·1–19·2]), followed by N meningitidis (13·6% [12·7–14·4]) and K pneumoniae (12·2% [10·2–14·3]). Between 1990 and 2019, H influenzae showed the largest reduction in the number of deaths among children younger than 5 years (76·5% [69·5–81·8]), followed by N meningitidis (72·3% [64·4–78·5]) and viruses (58·2% [47·1–67·3]). Interpretation: Substantial progress has been made in reducing meningitis mortality over the past three decades. However, more meningitis-related deaths might be prevented by quickly scaling up immunisation and expanding access to health services. Further reduction in the global meningitis burden should be possible through low-cost multivalent vaccines, increased access to accurate and rapid diagnostic assays, enhanced surveillance, and early treatment. Funding: Bill & Melinda Gates Foundation

Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes. Methods: We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2·5th and 97·5th percentiles across 1000 posterior draws for each quantity of interest. Findings: From an estimated 13·7 million (95% UI 10·9–17·1) infection-related deaths in 2019, there were 7·7 million deaths (5·7–10·2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13·6% (10·2–18·1) of all global deaths and 56·2% (52·1–60·1) of all sepsis-related deaths in 2019. Five leading pathogens—Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa—were responsible for 54·9% (52·9–56·9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185–285) per 100 000 population, and lowest in the high-income super-region, with 52·2 deaths (37·4–71·5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths. Interpretation: The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development. Funding: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care, using UK aid funding managed by the Fleming Fund