The effects of group play therapy on self-concept among 7 to 11 year-old children suffering from thalassemia major

Background: Children suffering from thalassemia have higher levels of depression and lower levels of self-concept. Objectives: The aim of this study was to determine if group play therapy could significantly increase self-concept among children with thalassemia major ages 7 to 11 years old in teaching hospitals of Golestan province, Iran, in 2012. Patients and Methods: In this randomized, controlled clinical trial, 60 children with thalassemia major were randomly assigned to intervention (30 children) and control (30 children) groups. The intervention included eight 45 to 60 minute sessions during four weeks, during which the intervention group received group play therapy. The control group received no interventions. Selfconcept was measured three times using the Piers-Harris children’s self-concept scale: before, immediately after, and a month after the intervention. Results: For the intervention group, results showed that the mean self-concept score was significantly higher at the second point in time compared to the baseline (P 0.05). Conclusions: The results showed that group play therapy improves self-concept in children suffering from thalassemia major. © 2016, Iranian Red Crescent Medical Journal

Investigation of relationship between social capital and quality of life in female headed families

Background: Although most studies on female-headed families focus on women's access to social support, the associations between social capital and quality of life in these families are unclear in many societies (such as Iran). This study aimed to determine the associations between social capital and quality of life in Iranian female headed families. Methods: This cross-sectional study was performed on 152 female-headed households supported by Tehran Municipality, district 9 from April 2011 to July 2012. Convenience sampling was employed. Data were collected using demographic questionnaire, the Iranian version of World Health Organization Quality of Life, and the Word Bank Social Capital. Descriptive and multiple regression methods were used to analyze the data. Results: The mean±SD age of participants was 50.8±13.8 years. Findings revealed that in quality of life, the domains of environment health and social relation received the lowest (9.87 ± 2.41) and the highest (12.61 ±3.43) scores respectively; and with respect to social capital, membership in groups and social trust had the least (19.61 ± 17.11) and the most (51.04 ± 17.37) scores, respectively. The multiple regression model revealed a significant positive association between total score of the quality of life and the total score for the social capital (p < 0.001). Conclusion: Findings suggest that quality of life of female-headed families and social capital domains are strongly related. This means that by improving the social capital, women's life can also be improved

Regional COVID-19 registry in Khuzestan, Iran: A study protocol and lessons learned from a pilot implementation

Disease registry systems provide a strong information infrastructure for decision-making and research. The purpose of this study is to describe the implementation method and protocol of the COVID-19 registry in Khuzestan province, Iran. We established a steering committee and formulated the purposes of the registry. Then, based on reviewing the literature, and expert panels, the minimum data set, the data collection forms and the web-based software were developed. Data collection is done retrospectively through Hospital Information Systems, Medical Care Monitoring Center system (MCMC), Management of Communicable Disease Prevention and Control system (MCDPC) as well as, patients' records. For prospective data collection, the data collection forms are compiled with patients' medical records by the medical staff and are then entered into the registry system. We collect patients' administrative and demographic data, history and physical examinations, test and imaging results, disease progression, treatment, outcomes, and follow-ups of the confirmed and suspected inpatients and outpatients. From April 20 to December 5, 2020, the data of 4,812 confirmed cases and 7,113 suspected cases were collected from two COVID-19 referral hospitals. Based on our experience, recording information along with providing care for patients and putting patients' data registration in the medical staff's routine, structuring data, having a flexible technical team and rapid software development for multiple and continuous updates, automating data collection by connecting the registry to existing information systems and having different incentives, the registration process can be strengthened. © 2021 The Author

Overuse and underuse of pulmonary CT angiography in patients with suspected pulmonary embolism

Background: The aim of the present study was to evaluate the utilization and diagnostic yields of CT pulmonary angiography (CTPA)using the Revised Geneva score and Wells' criteria, in patients with suspected pulmonary embolism (PE). Methods: One hundred and twelve adult patients underwent CTPA for suspected PE were participated in this study. The outcome was positive or negative CTPA for PE. Revised Geneva and Wells' scores were calculated. The relationship between the results obtained from these two scores and the available risk factors were compared. Descriptive analysis such as frequency and mean as well as analytical statistics including chi-square were done. The data analysis was performed using SPSS (v. 22). Results: In this study, according to the Wells' criteria calculated for the patients, 33.9 of the patients had low clinical, 56.3 intermediate and 9.8 high clinical probability. Among the 11 high clinical patients, 9(81.8) were CTPA positive. Based on the revised Geneva score, 65 patients (58) had low clinical, 36 (32.1) intermediate and 11(9.8) high clinical probability. Among the 11 high clinical patients, 8 were CTPA positive. Positive predictive value of the low clinical patients based on Wells' criteria and the revised Geneva score was 18.4 and 30.8, respectively. Also, positive predictive value for high clinical probability of Wells' criteria and the revised Geneva score was 81.8 and 72.8 respectively. Conclusion: Under/overuse of CTPA in diagnosing PTE is a common problem especially in university hospitals. It is possible to avoid unnecessary CTPA requests using scholarly investigations and more accurate clinical risk assessments. © Iran University of Medical Sciences

Overuse and underuse of pulmonary CT angiography in patients with suspected pulmonary embolism

Background: The aim of the present study was to evaluate the utilization and diagnostic yields of CT pulmonary angiography (CTPA)using the Revised Geneva score and Wells' criteria, in patients with suspected pulmonary embolism (PE). Methods: One hundred and twelve adult patients underwent CTPA for suspected PE were participated in this study. The outcome was positive or negative CTPA for PE. Revised Geneva and Wells' scores were calculated. The relationship between the results obtained from these two scores and the available risk factors were compared. Descriptive analysis such as frequency and mean as well as analytical statistics including chi-square were done. The data analysis was performed using SPSS (v. 22). Results: In this study, according to the Wells' criteria calculated for the patients, 33.9 of the patients had low clinical, 56.3 intermediate and 9.8 high clinical probability. Among the 11 high clinical patients, 9(81.8) were CTPA positive. Based on the revised Geneva score, 65 patients (58) had low clinical, 36 (32.1) intermediate and 11(9.8) high clinical probability. Among the 11 high clinical patients, 8 were CTPA positive. Positive predictive value of the low clinical patients based on Wells' criteria and the revised Geneva score was 18.4 and 30.8, respectively. Also, positive predictive value for high clinical probability of Wells' criteria and the revised Geneva score was 81.8 and 72.8 respectively. Conclusion: Under/overuse of CTPA in diagnosing PTE is a common problem especially in university hospitals. It is possible to avoid unnecessary CTPA requests using scholarly investigations and more accurate clinical risk assessments. © Iran University of Medical Sciences

Prenatal exposure to ambient air pollution and adverse pregnancy outcomes in Ahvaz, Iran: a generalized additive model

Objective: There is some evidence about the short-term effects of air pollutants on adverse pregnancy outcomes. The aim of this study was to determine the association between air pollutants and spontaneous abortion, stillbirth, gestational hypertension, preeclampsia, gestational diabetes and macrosomia in Ahvaz, which is one of the most polluted cities in the Middle East. Methods: Data on adverse pregnancy outcomes and air pollutants including ozone (O3), nitric oxide (NO), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), particles with a diameter of less than 10 µm (PM10) and particles with a diameter less than 2.5 µm (PM2.5) were inquired from the Health Department of Ahvaz Jundishapur University of Medical Sciences and the Environmental Protection Agency of Khuzestan Province for the years 2008�2018. A time series analysis using the generalized additive model (GAM) with up to 6-day lags was used. Results: The results showed that the SO2 pollutant on 0, 1, 3, 4, and 6-day lags and PM10 on lag 0 had direct and significant associations with spontaneous abortion. NO, NO2 and CO on 0�6-day lags, and O3 on 6-day lags showed direct and significant associations with preeclampsia. NO and NO2 pollutants showed significant and direct associations with gestational diabetes, during 0- and 6-day lags. NO on 0-, 3- and 4-day lags, CO in all 0�6-day lags and PM2.5 on 1-, 3-, 5-, and 6-day lags showed direct and significant associations with macrosomia. None of the pollutants showed significant associations with stillbirth or gestational hypertension. Conclusions: The results of this study suggest that some air pollutants are associated with spontaneous abortion, preeclampsia, gestational diabetes and macrosomia. This study further emphasizes the need to control ambient air pollution. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature

The prevalence of restless legs syndrome in chronic obstructive pulmonary disease (COPD) patients

To investigate the prevalence of restless legs syndrome (RLS) in chronic obstructive pulmonary disease (COPD) patients. The symptoms and severity of RLS was evaluated by the International Restless Legs Syndrome Group Study (IRLSSG). Mann�Whitney U test, Chi-square test and Spearman correlation coefficient were used to analyze the data. Out of the 109 COPD patients, 18.3 were diagnosed with RLS. There is no statistically significant difference between RLS and non-RLS groups except the mean age (P value > 0.05). Restless legs syndrome is relatively common in patients with COPD. © 2021, Japanese Society of Sleep Research

The effect of exercise therapy on cognitive functions in multiple sclerosis patients: A pilot study

BACKGROUND: The positive impacts of exercise therapy on patients' cognitive problems still remain unknown. This study was a pilot intervention to examine the effects of combined exercise on the cognitive problems of patients with multiple sclerosis (MS) in Iranian MS Society over 2012 to 2013. METHODS: This quasi-experimental research was carried out in the form of a pretest/posttest study. Forty two patients with MS were selected from those visiting the rehabilitation center of Iranian MS Society, using non-probability convenience sampling. The Expanded Disability Status Scale (EDSS) of each patient was recorded before the intervention and Brief Repeatable Battery of Neuropsychological (BRB-N) test was administered before and after the intervention. The data were analyzed using the analytical tests such as Wilcoxon test. RESULTS: Of 21 participants, 17 subjects (82%, n=14) female with mean (±SD) age of 37 (±9.98) years and mean (±SD) EDSS of 2.35 (±0.90) completed all stages of the study. Changes in long-term storage and permanent long-term retrieval of information after the intervention were statistically significant (p<0.001). In addition, the change in the average of total delay after the intervention was also significant by 1.11 (p<0.001). CONCLUSION: Our study confirmed the possibility of change in the cognitive abilities of MS patients through physical interventions. This finding emphasizes the necessity of more clinical examinations and increases the hopes for new rehabilitation methods for the disorder