Opium use and risk of mortality from digestive diseases: A prospective cohort study

Objectives:Opium use, particularly in low doses, is a common practice among adults in northeastern Iran. We aimed to investigate the association between opium use and subsequent mortality from disorders of the digestive tract.Methods:We used data from the Golestan Cohort Study, a prospective cohort study in northeastern Iran, with detailed, validated data on opium use and several other exposures. A total of 50,045 adults were enrolled during a 4-year period (2004-2008) and followed annually until December 2012, with a follow-up success rate of 99. We used Cox proportional hazard regression models to evaluate the association between opium use and outcomes of interest.Results:In all, 8,487 (17) participants reported opium use, with a mean duration of 12.7 years. During the follow-up period 474 deaths from digestive diseases were reported (387 due to gastrointestinal cancers and 87 due to nonmalignant etiologies). Opium use was associated with an increased risk of death from any digestive disease (adjusted hazard ratio (HR)=1.55, 95 confidence interval (CI)=1.24-1.93). The association was dose dependent, with a HR of 2.21 (1.57-3.31) for the highest quintile of cumulative opium use vs. no use (P trend =0.037). The HRs (95 CI) for the associations between opium use and malignant and nonmalignant causes of digestive mortality were 1.38 (1.07-1.76) and 2.60 (1.57-4.31), respectively. Increased risks were seen both for smoking opium and for ingestion of opium.Conclusions:Long-term opium use, even in low doses, is associated with increased risk of death from both malignant and nonmalignant digestive diseases

Exploring medical students’ perceptions of empathy after cinemeducation based on Vygotsky’s theory

Abstract Background Medical students’ empathy toward patients with Alzheimer’s is rarely found in formal medical curricula. Based on Vygotsky’s theory, watching films and reflection can be considered as effective methods to improve empathy. The present study aimed to explore medical students’ perceptions of empathy toward patients with Alzheimer after participating in an educational program by using interactive video based on Vygotsky’s theory. Methods This qualitative study was conducted at Tehran University of Medical Sciences in 2022. The population included all 40 medical students. Firstly, the Still Alice movie which is about the feelings of a professor who was diagnosed with Alzheimer’s disease was shown to the students. Secondly, the students reflected on their experiences of watching the movie. Thirdly, a session was held for group discussion on the subject of the movie, the patient’s feelings, the doctor’s attitude, the social environment surrounding the patient shown in the movie, and the necessity of empathy toward patients with Alzheimer’s disease. The reflection papers were analyzed using the conventional qualitative content analysis method. Results After analyzing 216 codes from 38 reflection papers, four categories, including communication with a patient with Alzheimer’s, understanding the patient with Alzheimer’s as a whole, medical science development, and the student’s individual ideology, were extracted. Conclusion Reflection and group discussion after watching movie by providing opportunities for social interaction about personal interpretations will lead to active role in enhancing empathy. Based on the perceptions of the medical students, they gained a perspective to consider the patient as a whole and pay attention to establishing a proper relationship with the patient

Burnout, Depression, and Anxiety in Teaching Professors of an Educational Hospital of Tehran University of Medical Sciences

Introduction: Burnout is prevalent in several physicians that may undermine the progress nad performance of physicians, reduced accessibility of patients to physicians, and patients’ safety. This study endeavored to determine burnout, anxiety, and depression in the specialists and attending physicians of one of the educational hospitals of Tehran University of Medical Sciences. Methods: This cross-sectional study conducted in the academic year 2018. One-hundred twenty-three physicians filled the Malach Burnout Inventory (MBI) questionnaire, Hospital Anxiety, and Depression Survey (HADS) questionnaires. Results: Forty-four physicians (35.8%) had some levels of burnout. Severe Emotional Exhaustion (EE) was seen in 18 physicians (14.6%). Likewise, severe Depersonalization (DP) in 12 physicians (9.8%), and severe dysfunction in Personal Accomplishment (PA) were seen in 33 physicians (26.8%). Four physicians (3%) had an abnormal level of anxiety, and 32 subjects (26%) were in the borderline zone. Four (3.2%) had abnormal depression, and 12 subjects (9.8%) had a borderline depression. There was a significant relationship between attending teacher type (i.e., educational, research, or treatment) and dysfunction of personal accomplishment (X2 = 12.24, p = 0.02). Moreover, anxiety was higher in non-married physicians (p = 0.046); anxiety was higher in part-time physicians as well (p = 0.03). Conclusion: Findings revealed that burnout is an essential issue in attending physicians of educational hospitals. Identifying and managing burnout and its adverse effects could eliminate further health complications for the physicians and under-treating patients

Prospective Acid Reflux Study of Iran (PARSI): Methodology and study design-1

<p><b>Copyright information:</b></p><p>Taken from "Prospective Acid Reflux Study of Iran (PARSI): Methodology and study design"</p><p>http://www.biomedcentral.com/1471-230X/7/42</p><p>BMC Gastroenterology 2007;7():42-42.</p><p>Published online 20 Nov 2007</p><p>PMCID:PMC2212633.</p><p></p> junction across the z-line, C: Cardia, D: Body, E: Antrum