The effects of diclofenac suppository and intravenous acetaminophen and their combination on the severity of postoperative pain in patients undergoing spinal anaesthesia during cesarean section

Introduction: The main tasks of postoperative care are postoperative pain and complications control which play an important role in accelerating the recovery of patient’s general condition. Aim: This study was performed in order to compare the effects of diclofenac suppository, intravenous acetaminophen and their combination on the severity of postoperative pain in patients undergoing spinal anaesthesia for cesarean section in Sayyad Shirazi teaching Hospital, Gorgon, Iran. Materials and Methods: This was a double-blind clinical trial on 90 patients undergoing cesarean section. The patients were randomly divided into three groups, group A: 100 mg diclofenac suppository, group B: 1000 mg intravenous acetaminophen, group C: 100 mg diclofenac suppository and 500 mg intravenous acetaminophen. The same spinal anaesthesia circumstances were applied for all the participants. At the end of surgery, pain severity was assessed according to VAS scale at different times. Data were then analysed by SPSS 18 statistical software. Results: The mean age of participants was (28.27±6.07). There was significant difference between the mean pain scores of the three groups before the intervention (p=0.018), which was considered as co-variate. This difference was more notable between the combination of acetaminophen - diclofenac group and diclofenac alone. After the intervention, significant difference was observed in mean pain severity between acetaminophen group and the combination group and also between diclofenac and the combination group. During the study, the least mean pain severity was found in the combination group and the highest was observed in the diclofenac group. Conclusion: Results of this study indicates a significant effect of concomitant use of intravenous acetaminophen and diclofenac suppository on pain severity reduction and reducing the need for repeated doses of narcotics and prolonging the postoperative analgesia. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved

Determinants of healthcare utilisation and predictors of outcome in colorectal cancer patients from Northern Iran

We aimed to assess healthcare utilisation (HU), its determinants, as well as its relationship with survival in colorectal cancer (CRC) patients. This study was conducted on incident CRC cases from Northern Iran. Information on HU was collected using a valid questionnaire, considering eight diagnostic and four therapeutic services. The results were categorised as good and poor HU. Multivariate logistic regression analysis was used to assess the relationship between HU and other variables. Cox regression analysis was performed to determine major predictors of survival. In total, 227 new cases of CRC were enrolled. HU could be assessed in 218 subjects (96). Living in rural areas was the strongest variable related to poor HU (adjusted OR, odds ratio=2.65; CI, confidence interval: 1.30-5.40). The median survival time was 40.5months. The 1-, 3- and 5-year survival rates were 71, 52 and 44 respectively. Cox regression analysis showed a significant lower survival rate in patients with poor HU (HR=2.3; CI: 1.46-3.64). HU was an independent predictor of survival in our CRC patients. Patients' place of residence was a significant determinant of HU. Regarding its effects on patients' outcome, HU and its determinants should be considered in designing CRC controlling programmes in our region and similar high-risk populations. © 2016 John Wiley & Sons Ltd

The Association of Causes of Reference and Selected Characteristics of Students who Attained to Golestan Medical University Counseling Center 2008-2009

Background and Objective: Students are under pressure and stress because of their status in the society. So the university’s student counseling agent is offering consultative services in order to help and guide the students in solving problems and improve their compatibility. The objective of the current study was to investigate the student’s referral proof to the Golestan university of medical sciences’counseling agent. Materials and Methods: In this cross- sectional study conducted in 2008-2009,On, via census sampling, 345 students of various fields, who referred to the counseling agent. Gathering data’s methods were based on questionnaire that is designed based on Health Ministry’s counseling agent’s goals. Data were analyzed by SPSS statistical software and descriptive statistics and chi square test and ANOVA with significance level of 0.05. Results: Referred student’s reference’s abundance to the counseling agent in the years 2008-2009 showed that from the whole 345 referred people the highest number of referrals by order were: 154 people (44.6%) because of mental problems, 66 people (19.1%) because of marriage problems, 45 people (13%) because of educating problems, 39 people (11.3%) because of communicating problems, 29 people(8.4%) because of suicide problems and 12 people (3.5%) were because of other factors. Conclusion: This article’s results are showing mental, emotional, educating, behaving, cognitive and family problems and also the student’s marriage’s problems. Cognition, diagnosis, adjustment and early removal of failures, abnormalities and possible disorders confirm mental caring systems expanding importance and supportive cures

Incidence of birth defects in Golestan province

Background and Objective: Birth defects are important causes of childhood morbidity and disability. This study was done to determine the incidence and pattern of birth defects in live birth in cities of Golestan province, north of Iran. Methods: This descriptive study was carried out on 92420 live births in 13 hospitals in Golestan province, northern Iran from 21 January 2008 to 20 March 2011. The newborns were examined for the presence of birth defects. Gender, type of birth defects and residency of parents according to city in Golestan province was recorded for each newborn. Results: The incidence rate of birth defects, in Gorgan, Kordkoy, Aliabad and Gonbad was 20.46, 12.53, 10.86, and 8.99 per 1,000 live births, respectively. The incidence rate of birth defects western area (including Kordkoy, Bandargaz and Kordkoy), center (Gorgan, Capital city) and eastern area (including Aliabad, Gonbad, Minodasht and Kalaleh) of Golestan province) was 9.3, 20.46 and 8.79 per 1,000 live births, respectively. Cardiovascular anomaly was the most frequent birth defects. Conclusion: The incidence rate of birth defects varies in diferent area of Golestan provine and overally was lower than the other region in Iran

Birth defects in Northern Iran (2008-2013)

Background: Congenital anomalies are important medical and public health conditions. The pattern and prevalence of birth defects may vary over time or with geographical location. We investigated the live birth prevalence and occurrence pattern of birth defects in Golestan Province, northern Iran. Methods: This cross-sectional descriptive study was carried out on 144920 live newborns in 13 hospitals in Golestan Province, northern Iran, from 21 Jan 2008 to 19 Mar 2013. The newborns were examined for the presence of birth defects and mothers were interviewed for variables such as maternal age and ethnicity. In addition, data for each newborn was filed in a questionnaire and the coding of birth defects was translated to the International Classification of Diseases 10th revision–clinical modification (ICD-10-CM). Results: Overall, 1690 infants were diagnosed as having birth defects among 144920 live newborns. The prevalence rate of birth defects was 11.66 per 1000 live births, the prevalence of birth defects per 1000 was11.62 in males and 11.42 in females. The prevalence of congenital anomalies among native Fars, Turkmen and Sistani were 13.03, 11.16 and 13.07, respectively, per 1000 live births. Anomalies of the cardiovascular system were the most common defects; the prevalence rate of cardiovascular system was 8.34 per 1000 live birth. Conclusion: The prevalence rate of birth defects in this area was lower than in the other regions in Iran (20.3 per 1000 live births) but higher than in some parts of Asia (7.33 per 1000 live births). © 2018, Iranian Journal of Public Health. All rights reserved

Epidemiological Study of Poisoning in Teaching Hospitals in Shiraz in 1387

Background/Objective: Poisoning is One common cause of referred cases , especially in the adolescent and young group to hospital emergency department. This study was designed to determine Epidemiologic of poisoning in teaching hospitals, shiraz in 1387 Methods: This is a cross-sectional study that 266 sample via random sampling with 95% confidence interval and α 0.05 were considered. Results: There were 47% female and 53% male. 67.2 percent of poisoned patient were single and 32.8% were married. This study showed, highest rate of poisoning was between the age of 20-35 years. Most common season of poisoning was in spring. Overall mortality of our study was 1.6 percent. Conclusions: Regional epidemiological information, make rational use of resources in order to prevention and control of poisoning and with using analysis of effective factors will be reduced poisoning by policymakers and planners

Evaluation of thyroid dysfunction and thyroid autoantibodies in patients with Vitiligo

Background and Objective: Vitiligo is one of the most frequent skin disorders with a prevalence of 1-2% in different populations. Although many theories have been suggested for its pathogenesis, but the most popular hypotheses is the role of autoimmunity in Vitiligo. This study was done to evaluate the thyroid dysfunction and thyroid autoantibodies in patients with Vitiligo. Methods: This case-control study was carried out on 45 patients with Vitiligo and 45 age- and sex-matched healthy individuals as control group. Age, gender, duration of the disease and type of Vitiligo were collected through a standard questionnaire. Thyroid autoantibodies including thyroglobulin antibody, anti- thyroglobulin and thyroid peroxidase antibody, and anti-TPO thyroid hormones Tetraiodothyronine (T4), Triiodothyronine (T3) and thyroid stimulating hormone (TSH) in Vitiligo patients and healthy volunteers were measeared. Results: Serum level of T4 was significantly reduced in Vitiligo patient compared to controls (P<0.05). Serum level of T4 in 20% of Vitiligo patient and 2.2% of control cases was less the normal level. Anti-TPO in 14 (31.1%) of Vitiligo patient and 6 (13.3%) of controls were higher than normal range (<60 IU/m) (P<0.05). Serum level of anti- thyroglobulin was significantly higher in those with Vitiligo in compared to controls (P<0.05). Conclusion: This study showed that the thyroid dysfunction particularly hypothyroidism and anti-TPO is more common in Vitiligo patients

Unemployment and COVID-19-related mortality: a historical cohort study of 50,000 COVID-19 patients in Fars, Iran

OBJECTIVES: Previous studies have estimated the risk of death associated with unemployment in the coronavirus disease 2019 (COVID-19) pandemic, but no studies have examined unemployment before COVID-19 infection as a risk factor for COVID-19-related mortality. Thus, this study aimed to investigate COVID-19 mortality among this population. METHODS: Data on 50,038 people aged 25-59 years were collected from 38 agencies in Fars Province, Iran, from February 2020 to July 2021. Follow-up lasted from participants� diagnosis with COVID-19 based on the results of a reverse transcription-polymerase chain reaction test to participants� death or the end of the study period. The association between unemployment and COVID-19-related mortality was estimated using the Poisson regression method, and a sensitivity analysis was conducted to calculate the E-value. RESULTS: Unemployment was associated with a 2.41-fold (95 confidence interval CI, 2.01 to 2.90) higher age-adjusted and sex-adjusted risk of COVID-19-related mortality. The adjusted Poisson regression analysis showed 8.82 (95% CI, 6.42 to 12.11), 2.84 (95% CI, 1.90 to 4.24), and 1.58 (95% CI, 1.24 to 2.01) times higher risks of COVID-19-related mortality among unemployed people aged 25-39 years, 40-49 years, and 50-59 years, respectively, than among their employed counterparts. Unemployment increased the risk of COVID-19 mortality by 3.31 (95% CI, 2.31 to 4.74) and 2.30 (95% CI, 1.86 to 2.84) times in female and male, respectively. The E-value was 3.43, reflecting the minimum strength of confounding required to shift the association between unemployment and COVID-19-related mortality toward the null. CONCLUSIONS: Unemployment prior to COVID-19 infection increased the risk of COVID-19-related mortality. COVID-19-related mortality disproportionately impacted unemployed women and younger unemployed people. ©2022, Korean Society of Epidemiolog

Modifying attitude and intention toward regular physical activity using protection motivation theory: A randomized controlled trial Modification de l’attitude et de l’intention vis-à-vis d’une activité physique régulière à l’aide de la théorie de la motivation à la protection: Essai contrôlé randomisé

We were guided by the Protection Motivation Theory to test the motivational interviewing effects on attitude and intention of obese and overweight women to do regular physical activity. In a randomized controlled trial, we selected using convenience sampling 60 overweight and obese women attending health centres. The women were allocated to 2 groups of 30 receiving a standard weight-control programme or motivational interviewing. All constructs of the theory (perceived susceptibility, severity, self-efficacy and response efficacy) and all anthropometric characteristics (except body mass index) were significantly different between the groups at 3 study times. The strongest predictors of intention to do regular physical exercise were perceived response efficacy and attitude at 2- and 6-months follow-up. We showed that targeting otivational interviewing with an emphasis on Protection Motivation Theory constructs appeared to be beneficial for designing and developing appropriate intervention to improve physical activity status among women with overweight and obesity. © 2017, World Health Organization. All rights reserved

Demographic and clinical characteristics of children with cutaneous leishmaniasis in Isfahan province, Iran, during 2011-2015

Background: Leishmaniasis is a parasitic disease caused by protozoan called Leishmania that is transmitted by sand flies. The aim of this study was to determine the demographic and clinical characteristics of children with cutaneous leishmaniasis in Isfahan province, Iran. Methods: This was a cross-sectional study on all children patients with age of five years and younger in Isfahan province during 2011 to 2015. Demographic and clinical characters of patients were presented as the number and percentage. The mean age of patients according to sex was compared using t test via SPSS software. Findings: Of 1529 patients, 51.8 were boys, 56.0 were in rural areas, and 92.9 were Iranian. The mean age of patients (± SD) was 2.71 ± 1.5 years. The smallest patient was 2 months old. Most of the patients were in the age group of one year (20.4) and the lowest were in the age group of less than one year (5.6). Leishmania major was the most common (91.8) cause of disease. Wound size at 63.37 of patients was more than 2 cm. In 11.2 of patients the number of wounds was equal or more than 4 wound. In children, face was the most common (33.7) region of wound. Conclusion: Leishmaniasis is endemic in Isfahan province, and children are in high risk for incidence of disease. However, the process for combating the animal reservoirs and mosquito vector should be considered as a priority to control the disease. Furthermore, the facilities should be provided for accurate and timely diagnosis and treatment of patients. © 2017, Isfahan University of Medical Sciences(IUMS). All rights reserved