Intraoperative administration of methadone reduced postoperative pain and opioid consumption following cadaveric renal transplantation: a randomized controlled trial

Objective: In this randomized clinical trial study, the impact of prophylactic administration of methadone during surgery on postoperative pain and analgesic requirement following cadaveric renal transplantation was assessed. Methods: Ninety patients were randomized to receive either methadone 0.15 mg/kg or 0.15mg/kg morphine after tracheal intubation. Both groups were treated with acetaminophen 1 gr before extubation. Protocol of anesthesia was the same in both groups and the anesthetist was blinded to the study groups. The primary outcome was defined as total opioid consumption during recovery and first day after surgery. Secondary outcomes were pain scores and level of patients’ sedation during the recovery period and first postoperative day as well as opioid-related complications. Results: Data of eighty-five eligible patients were analyzed. The mean pain and sedation scores were lower in the methadone group compared to the morphine group during recovery and the first 24 hours after surgery. The time of first rescue analgesic requirement was later in the methadone group (10.4 vs 6.3 hours). Also, postoperative morphine consumption was significantly less in the methadone group compared to patients receiving morphine (3.5 vs. 6.9 mg; P < 0.001). Conclusion: Intraoperative administration of methadone decreased postoperative pain scores, reduced opioid consumption after surgery and improved level of sedation during the first 24 hours after surgery

A Non-Inferiority Study of the Speed and Success of Nasotracheal Intubation in Maxillofacial Surgeries Using Macintosh Direct Laryngoscope versus Sanyar® Video Laryngoscope

Background: The recently developed blade design of the Sanyar® video laryngoscope yields an exceptionally precise visualization of the larynx, thereby easing the process of tracheal intubation. Objectives: A non-inferiority clinical investigation, to assess the efficacy of the Sanyar® as compared to the Macintosh® direct laryngoscope for nasotracheal intubation in the context of maxillofacial surgeries. Methods: 78 patients for maxillofacial surgery were divided randomly into two groups and intubated through the nose using either the Sanyar® or Macintosh® laryngoscope after anesthesia was induced. The study measured intubation time and secondary objectives included success rate, attempts, and hemodynamic changes in two groups. Results: 40 eligible patients in the Sanyar® and 38 in the Macintosh® group were involved. Of all, 42(53.8%) were men and 36(46.2%) were women. The average age of patients in the Sanyar® and Mackintosh groups was (31.62±13.41) and (30.81±10.89), respectively. 39(98%) of the Sanyar® group and 33(86%) of the Macintosh® group had successful laryngoscopy and intubation, with a P-value<0.034. Sanyar® group had a significantly shorter intubation time than Macintosh® (P-value<0.001). Hemodynamic changes before and after laryngoscopy and intubation had no significant differences between the two groups. Conclusion: The Sanyar® video laryngoscope reduced the time of nasal tracheal intubation in maxillofacial surgery compared to direct laryngoscopy and improved the success rate of the first intubation attempt

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

The Study of Relationship between Life Satisfaction and Tendency to Addiction in Students of Qom University of Medical Sciences, (Iran)

Background and Objectives: Dissatisfaction with life and use of drugs in adolescents is a worrying problem, since each of these problems is associated with many negative consequences. The purpose of this study was to investigate the relationship between life satisfaction and tendency to addiction in the students of Qom University of Medical Sciences.   Methods: This cross-sectional descriptive-analytical study, was performed on all students of Qom University of Medical Sciences. Statistical population consisted of 250 individuals who were selected with systematic random sampling in the second semester of academic year 2016-2017 and responded to demographic characteristics, Diener’s Satisfaction with Life, and Tendency to Addiction questionnaires. Data were analyzed using Pearson correlation coefficient and regression at a significant level of p<0.05.   Results: The mean of students' tendency to addiction was 32.03+19.25 and the mean of student's life satisfaction was 23.7+6.19. Also, there was a significant reverse relationship between life satisfaction and tendency to addiction among the students.   Conclusion: The results of this study showed that increasing life satisfaction is associated with a decrease in tendency to addiction in the students. Therefore, planning is necessary to improve the satisfaction with life during the academic period and reduce the tendency to addiction in this group of society

Estimating the potential impact fraction of hypertension as the main risk factor of stroke: Application of the distribution shift method

Few published studies have assessed the impact of quantitative risk factors such as high blood pressure on stroke. The aim of this study was to quantify the potential impact fraction (PIF) of hypertension on stroke in Hamadan Province, western Iran. Avoidable burden of stroke associated with high blood pressure was calculated using distribution shift at different scenarios. Data on the prevalence of high blood pressure among residents of Hamadan province older than 19 years were extracted from non-communicable diseases risk factors surveillance system in 2009. Five mmHg hypothetical reduction in systolic blood pressure above 140 mmHg, leads to 3.5% (PIF = 0.035) reduction in the total burden to stroke. This value may reach 7%, if systolic blood pressure decreases 10 mmHg. In addition, 5 mmHg hypothetical reduction in diastolic blood pressure above 82 mmHg, leads to 4.87% reduction in the total burden to stroke. PIF more than 10 mmHg modification on distribution of diastolic blood pressure was estimated as 9.38%. According to these findings, policy makers are advised to implement interventions on hypertension based on the distribution shift method rather than the proportion shift one

sj-pdf-3-smo-10.1177_20503121231220216 – Supplemental material for Does adult socioeconomic status mediate the relationship between adolescent socioeconomic status and adult quality of life?

Supplemental material, sj-pdf-3-smo-10.1177_20503121231220216 for Does adult socioeconomic status mediate the relationship between adolescent socioeconomic status and adult quality of life? by Azam Biderafsh, Abbas Rahimi foroushani and Saharnaz Nedjat in SAGE Open Medicine</p

sj-pdf-2-smo-10.1177_20503121231220216 – Supplemental material for Does adult socioeconomic status mediate the relationship between adolescent socioeconomic status and adult quality of life?

Supplemental material, sj-pdf-2-smo-10.1177_20503121231220216 for Does adult socioeconomic status mediate the relationship between adolescent socioeconomic status and adult quality of life? by Azam Biderafsh, Abbas Rahimi foroushani and Saharnaz Nedjat in SAGE Open Medicine</p

sj-docx-1-smo-10.1177_20503121231220216 – Supplemental material for Does adult socioeconomic status mediate the relationship between adolescent socioeconomic status and adult quality of life?

Supplemental material, sj-docx-1-smo-10.1177_20503121231220216 for Does adult socioeconomic status mediate the relationship between adolescent socioeconomic status and adult quality of life? by Azam Biderafsh, Abbas Rahimi foroushani and Saharnaz Nedjat in SAGE Open Medicine</p

The Effect of Antiviral Therapy with Tenofovir on Liver Fibrosis and Liver Function in Patients with Chronic Hepatitis B

Background and Objectives: Chronic viral hepatitis B is a global health problem, which, if not treated, can lead to some serious complications, such as liver cirrhosis and hepatocellular carcinoma. In this study, the effect of antiviral therapy with tenofovir, was investigated on reduction of liver fibrosis and improvement of liver function in patients with chronic hepatitis C. &nbsp; Methods: In this clinical trial, 40 patients with chronic hepatitis B underwent antiviral therapy with tenofovir 300 mg daily. Demographic information and results of laboratory tests (before treatment and 6 months after the start of treatment), were collected using a checklist. Liver stiffness was measured and recorded using a fibroscan device (before and 6 months after the treatment). Data were analyzed using Wilcoxon and paired t- tests. The level of significance was considered to be p<0.05. &nbsp; Results: Among 40 patients, one person was excluded from the project due to lack of follow-up. Of remaining 39 patients, 27 subjects (69.2%) were male and 12 subjects (30.8%) were female. The mean age of the patients was 47.53&plusmn;13.68 years. The mean levels of AST, ALT, Child score, and liver stiffness did not show significant improvement during a 6-month follow-up according to Wilcoxon and paired t- tests. &nbsp; Conclusion: This study showed that although hepatic fibrosis and liver function in patients with chronic hepatitis B are reversible after treatment, changes require long-term treatment and follow-up. &nbsp

The Epidemiology of Aggression and Associated Factors among Iranian Adult Population: A National survey

Background: This survey was conducted to determine the level of aggression among the Iranian adult population and underlying predisposing factors. Study design: A cross-sectional study. Methods: This cross-sectional study included 10,957 participants, involving 23 out of the 31 provinces of Iran in 2019. The outcome of interest was aggression, evaluated by the Buss & Perry aggression questionnaire. The association between aggression and 34 demographic, behavioral, social, and cultural characteristics was assessed using simple and multiple linear regression. Results: The overall mean (SD) score of aggression was 77.10 (22.53). Based on the severity of aggression, the participants were categorized into four groups as follows: 2,464 (23.1%) nonaggressive, 4,692 (43.9%) mild, 3,071 (28.8%) moderate, and 454 (4.2%) severe aggressive. Aggression was more likely to occur in people with the following characteristics: younger ages, having several siblings, lower ranks of birth, having an intimate friend of the opposite sex, having an aggressive father/mother, history of parental divorce, interest in watching action/porn movies, listening to music, history of escape from home/school, using neuropsychiatric drugs, using illicit drugs, history of suicidal thoughts/attempt, and family conflict and hostility. Aggression was less likely to occur with the following characteristics: reading, regular physical exercise, the ability to control anger, regular prayer, adherence to avoid lying, respect to other people's rights, sexual satisfaction, and attachment to parents. Conclusions: A majority of the population has some degree of aggression. Aggression is a multifactorial behavior corresponding with several demographical, social, cultural, and religious factors, some of which back to early childhood events