Can integrating religiosity and spirituality into postpartum care improve the quality of life in women with preeclampsia

BackgroundWomen with a history of preeclampsia frequently have a lower level of physical well-being and emotional problems.ObjectiveThis study aimed to determine the effect of integrating religiosity and spirituality into postpartum care can improve the quality of life in women with preeclampsia.MethodsThis study was a randomized controlled clinical trial conducted on 40 women with preeclampsia. All eligible participants were allocated to two control and intervention groups using a random blocking method. Data were collected using Mother-Generated Index (MGI) in pre-intervention and 6 weeks later and analyzed using descriptive statistics, Chi-square test, and independent t-tests. The significance level was p < 0.05.ResultsThe mean, Standard deviation (SD) of the total score of MGI before intervention in the intervention group was 5.35 (1.09) which increased to 8.00 (0.50) 6 weeks after intervention. In the control group, the pre-test score of MGI was 5.81 (0.97) which increased to 6.69 (1.37) after 6 weeks of follow-up. The difference between the two groups was statistically significant after the intervention based on an independent t-test (p = 0.001).The mean (SD) of five subscales included Feelings toward herself, Feelings toward the child, Feelings toward her husband and others, Feelings toward sex, and Physical health status after intervention in the intervention group statistically significantly increased compared to the control group (p < 0.011).ConclusionThe integration of spiritual counseling with the educational content of postpartum care had a positive impact on improving the postpartum QoL of women with preeclampsia. For better conclusions, a study with a large sample size needed to be conducted in the future.Clinical Trial Registrationhttps://en.irct.ir/user/trial/50832/view, identifier IRCT20150731023423N16

Knowledge of Emergency Contraception among College Students in Zanjan, Iran

Background & aim: Avoiding unintended pregnancy is an important issue among college students. Emergency contraception is considered as a practical method to prevent pregnancy after unprotected sex. This study was conducted to measure the knowledge of college students regarding emergency contraception in Zanjan, Iran. Methods: This cross-sectional study was conducted among 911 college students, who were studying humanity, engineering, and experimental sciences in Zanjan, Iran, during 2011 to 2012. The subjects were selected using stratified random sampling method, and the data were collected by a questionnaire developed by the researcher. The level of knowledge was considered as low, moderate, and high. Data analysis was performed using Chi-square test in SPSS software, version 16. Results: According to the results, 78 (8.6%), 279 (30.9%), and 545 (60.4%) of the students had high, moderate, and low levels of knowledge about emergency contraception, respectively. Additionally, 524 individuals (58.28%) had heard about emergency contraception so far. Furthermore, 256 (28.6%) students knew about combined oral contraceptive pills, and 64 (7.2%) of them knew about intrauterine device with copper as an emergency contraception. There was a significant relationship between marital status and the level of knowledge (P=0.01). Conclusion: The results showed that the students had inadequate knowledge about the methods of emergency contraception. Conducting educational programs and making students aware through the media may be helpful for increasing their level of knowledge

A Comprehensive Review on Risk Factors Affecting the Crash Severity

As a matter of growing machinery life, traffic crashes are considered an inevitable source of injuries and costs around the world. Regarding to increasing traffic accident outcomes, controlling the current status is necessary. In this way, identifying risk factors affecting the crash severity is an essential step toward initiating a convincing solution. The core objective of this study was to categorize the risk factors affecting the severity of crashes. Data needed for this study were gathered through searching Web of Science, Google Scholar, and Science Direct databases using the keywords included fatal and crash, injuries and crash, fatal and traffic accident, and injuries and traffic accident. Based on 83 selected studies for review, factors affecting the crash severity divided into five factors and forty-seven sub-factors. The most prevalent sub-factors were age, sex, safety belts, alcohol and drug use, speed, weather conditions, lighting conditions, time of the day and week, vehicle kind, road condition, collision type and crash location. Many risk factors affect crash severity and determination of the most important ones can be a prelude in reducing the effects. Therefore, the conclusion of this review can assist to traffic safety experts, police and contribute to distinguishing and monitoring the risk factors affecting crash severity transportation agencies

Cross-Cultural Adaptation, Validity, and Reliability of the Persian Version of the Orebro Musculoskeletal Pain Screening Questionnaire

Study DesignObservational study.PurposeTo cross-culturally translate the Orebro Musculoskeletal Pain Screening Questionnaire (OMPQ) into Persian and then evaluate its psychometric properties (reliability, validity, ceiling, and flooring effects).Overview of LiteratureTo the authors' knowledge, prior to this study there has been no validated instrument to screen the risk of chronicity in Persian-speaking patients with low back pain (LBP) in Iran. The OMPQ was specifically developed as a self-administered screening tool for assessing the risk of LBP chronicity.MethodsThe forward–backward translation method was used for the translation and cross-cultural adaptation of the original questionnaire. In total, 202 patients with subacute LBP completed the OMPQ and the pain disability questionnaire (PDQ), which was used to assess convergent validity. 62 patients completed the OMPQ a week later as a retest.ResultsSlight changes were made to the OMPQ during the translation/cultural adaptation process; face validity of the Persian version was obtained. The Persian OMPQ showed excellent test–retest reliability (intraclass correlation coefficient=0.89). Its internal consistency was 0.71, and its convergent validity was confirmed by good correlation coefficient between the OMPQ and PDQ total scores (r=0.72, p<0.05). No ceiling or floor effects were observed.ConclusionsThe Persian version of the OMPQ is acceptable for the target society in terms of face validity, construct validity, reliability, and consistency. It is therefore considered a useful instrument for screening Iranian patients with LBP

Ameliorative effects of crocin against electromagnetic field-induced oxidative stress and liver and kidney injuries in mice

Objective: The current study's goal was to examine how crocin affects organ damage such as damage to the kidney and liver in mice treated by 2100 MHz Electro Magnetic Field.Materials and Methods: The liver and kidneys of mice exposed to EMFs were used in this study to examine how crocin affected them. 24 male NMARI mice were randomly divided into 4 groups: EMF group (2100 MHZ); Crocin (Cr) group (50 mg/kg); EMF+Crocin group (2100 MHZ+50 mg/kg), and control group. The antioxidant enzymes and some serum biochemical parameters were assessed in blood samples collected after the experiment. After the animals were put to sleep, liver and kidney samples were taken for histopathological and liver samples were taken for ultrastructural analysis.Results: The serum levels of urea and creatinine, and serum activities of alanine transaminase, aspartate transaminase, and alkaline phosphatase were higher in the EMF group than the control group, and this difference was significant. When compared to the control group, the EMF group's antioxidants, (catalase and superoxide dismutase) activity were decreased. These metrics significantly improved in the EMF + Cr group when compared to the EMF group. Different pathological damages were present in the liver and kidney of the EMF group, and the liver's ultrastructure had changed. Crocin administration decrease these changes.Conclusion: Crocin, an antioxidant agent, may provide defense against tissue damage brought on by EMF by reducing oxidative stress

High prevalence of mental disorders: a population-based cross-sectional study in the city of Ilam, Iran

AimTo determine the age- and sex-standardized prevalence and risk factors of depression, anxiety, and stress symptoms in the city of Ilam.MethodIn this population-based cross-sectional study, 1,350 people were invited using a multi-stage stratified cluster random sampling method. Depression, anxiety, and stress symptoms were measured using the DASS-21 standard questionnaire. For data analysis, multiple ordinal logistic regression was used in Stata version 12 software. A significance level of 5% was considered.ResultsThe data of 1,431 people were analyzed. The age- and sex-standardized prevalence (95% CI) of severe depression, anxiety, and stress symptoms was 19.90% (17.64 to 22.16), 25.95% (23.48 to 28.43), and 15.75% (13.69 to 17.81), respectively. There was a positive association among depression symptoms with female sex (OR: 1.52; p &lt; 0.003), Kurdish ethnicity (OR: 2.15; p &lt; 0.004), low educational level (OR: 1.37; p &lt; 0.031), job losing history (OR: 1.64; p &lt; 0.001), mental disorders history (OR: 2.17; p &lt; 0.001), hopelessness for the future (OR: 5.38; p &lt; 0.001), and history of other diseases (OR: 1.67; p &lt; 0.001). There was a positive association among anxiety symptoms with female sex (OR: 1.72; p &lt; 0.001), job losing history (OR: 1.53; p &lt; 0.003), mental disorders history (OR: 2.11; p &lt; 0.001), hopelessness to future (OR: 3.33; p &lt; 0.001) and history of other diseases (OR: 1.97; p &lt; 0.001). Hopelessness for the future and a history of other diseases were the most effective variables for anxiety symptoms and stress symptoms.ConclusionA significant proportion of Ilam’s urban population suffers from mental disorders. Increasing people’s awareness, establishing counseling centers, and improving infrastructure should be considered by mental health policymakers who work in the province

Detection and Management of Common Medication Errors inInternal Medicine Wards: Impact on Medication Costs and Patient Care

Introduction: Medication errors (MEs) are a leading cause of morbidity and mortality, yet they have remained as confusing and underappreciated concept. The complex pharmacotherapy in hospitalized patients and sometimes serious clinical consequences of MEs necessitate continued report and surveillance of MEs as well as persistent pharmaceutical care for patients at medical wards. This study evaluated the frequency, types, clinical significance, and costs of MEs in internal medicine wards. Method: In this 8-month prospective and cross-sectional study, an attending clinical pharmacist, as an integral member of a health care team, visited the patients during each physician's ward round at the morning. All MEs including prescription, transcription, and administration errors were detected, recorded, and subsequently appropriate corrective interventions were proposed during these rounds. The changes in the medications' cost after implementing clinical pharmacist's interventions were compared to the calculated medications' cost, assuming that the MEs would not have been detected by clinical pharmacist and continued up to discharge time of the patients. Results: 89% of the patients experienced at least one ME during their hospitalization. A mean of 2.6 errors per patient or 0.2 errors per ordered medication occurred in this study. More than 70% of MEs happened at the prescription stage by treating physicians. The most prevalent prescription errors were inappropriate drug selection, unauthorized drugs and untreated indication. The highest MEs occurred on cardiovascular agents followed by antibiotics, and vitamins, minerals, and electrolytes. Total number of MEs showed a marked correlation with the total number of ordered medications and patients’ length of hospitalization. The net effect of clinical pharmacist’s contributions in medication therapy management was to decline medications’ costs by 33.9%. None of the MEs caused the patients harm. Conclusion: The role of clinical pharmacy services in detection, prevention and reducing the cost of MEs is of paramount importance to internal medicine wards. Key words: clinical pharmacist; medication errors; pharmaceutical care; internal medicine

A Comparative Analysis of Clinical Characteristics and Laboratory Findings of COVID-19 between Intensive Care Unit and Non-Intensive Care Unit Pediatric Patients: A Multicenter, Retrospective, Observational Study from Iranian Network for Research in Viral

Introduction: To date, little is known about the clinical features of pediatric COVID-19 patients admitted to intensive care units (ICUs).&nbsp;Objective: Herein, we aimed to describe the differences in demographic characteristics, laboratory findings, clinical presentations, and outcomes of Iranian pediatric COVID-19 patients admitted to ICU versus those in non-ICU settings.&nbsp;Methods: This multicenter investigation involved 15 general and pediatrics hospitals and included cases with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection based on positive real-time reverse transcription polymerase chain reaction (RT-PCR) admitted to these centers between March and May 2020, during the initial peak of the COVID-19 pandemic in Iran.&nbsp;Results: Overall, 166 patients were included, 61 (36.7%) of whom required ICU admission. The highest number of admitted cases to ICU were in the age group of 1–5 years old. Malignancy and heart diseases were the most frequent underlying conditions. Dyspnea was the major symptom for ICU-admitted patients. There were significant decreases in PH, HCO3 and base excess, as well as increases in creatinine, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), and potassium levels between ICU-admitted and non-ICU patients. Acute respiratory distress syndrome (ARDS), shock, and acute cardiac injury were the most common features among ICU-admitted patients. The mortality rate in the ICU-admitted patients was substantially higher than non-ICU cases (45.9% vs. 1.9%, respectively; p&lt;0.001).&nbsp;Conclusions: Underlying diseases were the major risk factors for the increased ICU admissions and mortality rates in pediatric COVID-19 patients. There were few paraclinical parameters that could differentiate between pediatrics in terms of prognosis and serious outcomes of COVID-19. Healthcare providers should consider children as a high-risk group, especially those with underlying medical conditions

The unfinished agenda of communicable diseases among children and adolescents before the COVID-19 pandemic, 1990-2019: a systematic analysis of the Global Burden of Disease Study 2019

BACKGROUND: Communicable disease control has long been a focus of global health policy. There have been substantial reductions in the burden and mortality of communicable diseases among children younger than 5 years, but we know less about this burden in older children and adolescents, and it is unclear whether current programmes and policies remain aligned with targets for intervention. This knowledge is especially important for policy and programmes in the context of the COVID-19 pandemic. We aimed to use the Global Burden of Disease (GBD) Study 2019 to systematically characterise the burden of communicable diseases across childhood and adolescence. METHODS: In this systematic analysis of the GBD study from 1990 to 2019, all communicable diseases and their manifestations as modelled within GBD 2019 were included, categorised as 16 subgroups of common diseases or presentations. Data were reported for absolute count, prevalence, and incidence across measures of cause-specific mortality (deaths and years of life lost), disability (years lived with disability [YLDs]), and disease burden (disability-adjusted life-years [DALYs]) for children and adolescents aged 0-24 years. Data were reported across the Socio-demographic Index (SDI) and across time (1990-2019), and for 204 countries and territories. For HIV, we reported the mortality-to-incidence ratio (MIR) as a measure of health system performance. FINDINGS: In 2019, there were 3·0 million deaths and 30·0 million years of healthy life lost to disability (as measured by YLDs), corresponding to 288·4 million DALYs from communicable diseases among children and adolescents globally (57·3% of total communicable disease burden across all ages). Over time, there has been a shift in communicable disease burden from young children to older children and adolescents (largely driven by the considerable reductions in children younger than 5 years and slower progress elsewhere), although children younger than 5 years still accounted for most of the communicable disease burden in 2019. Disease burden and mortality were predominantly in low-SDI settings, with high and high-middle SDI settings also having an appreciable burden of communicable disease morbidity (4·0 million YLDs in 2019 alone). Three cause groups (enteric infections, lower-respiratory-tract infections, and malaria) accounted for 59·8% of the global communicable disease burden in children and adolescents, with tuberculosis and HIV both emerging as important causes during adolescence. HIV was the only cause for which disease burden increased over time, particularly in children and adolescents older than 5 years, and especially in females. Excess MIRs for HIV were observed for males aged 15-19 years in low-SDI settings. INTERPRETATION: Our analysis supports continued policy focus on enteric infections and lower-respiratory-tract infections, with orientation to children younger than 5 years in settings of low socioeconomic development. However, efforts should also be targeted to other conditions, particularly HIV, given its increased burden in older children and adolescents. Older children and adolescents also experience a large burden of communicable disease, further highlighting the need for efforts to extend beyond the first 5 years of life. Our analysis also identified substantial morbidity caused by communicable diseases affecting child and adolescent health across the world. FUNDING: The Australian National Health and Medical Research Council Centre for Research Excellence for Driving Investment in Global Adolescent Health and the Bill & Melinda Gates Foundation