The Quality of Maternity Services in Mashhad Educational Hospitals, Using SERVUSE Model

Introduction: Reducing maternal and neonatal mortality requires improved care quality; the aim of this study was to determine various dimensions of the quality of services in maternity wards in Iran from the patient’s perspective. Methods: In this cross-sectional study which was conducted from April to October 2017, 363 patients were selected from maternity wards of five hospitals affiliated to Mashhad University of Medical Sciences by convenience sampling method. Data collection tools consisted of the SERVUSE (Service Usability questionnaire), including 51 items in 6 dimensions of services quality; its validity and reliability were determined in previous studies. Data analysis was performed using SPSS, version 20. The analysis was performed using descriptive and inferential statistical methods including Wilcoxon, Kruskal Wallis and Mann-Whitney tests. The significance level in all the tests was considered 5%. Results: The total mean scores of the patients’ expectation and perception were 19.10±2.14 and 15.11±4.25, respectively. The highest expectation and perception were related to the usability dimension, and the lowest expectation and perception were related to reliability dimension. The differences between the median score of perception and expectation for all dimensions and total median score of perceptions and expectations were statistically significant (P<0.05, using Wilcoxon test). There were no statistically significant differences in the median score of the gap between the patient’s expectations and perceptions at the levels of demographic variables (P>0.05, using Mann-Whitney and Kruskal Wallis tests). Conclusion: It seems that the service quality of maternity ward of hospitals was approximately unsatisfactory from the patients’ perspective, and they had high expectations in maternity wards of hospitals. Since maternity service quality is critically important, improvement of quality requires management, concordant participation, and efforts of the hospital and staff at all levels of the medical facilities and convenience

Lupoid leishmaniasis among the known cases of cutaneous leishmaniasis in Herat Province, western Afghanistan

Summary: Lupoid cutaneous leishmaniasis (LCL) is an uncommon form of chronic cutaneous leishmaniasis, which is mostly caused by Leishmania tropica in the Old World and has a high incidence throughout early life. Between 2012 and 2013, patients with active lesions suspected to be cutaneous leishmaniasis (CL) were examined. Diagnosis was performed through a combination of methods, i.e., clinical examination, direct smears and kDNA polymerase chain reaction (PCR). Overall, 162(4.2%) subjects, through clinical examination and PCR confirmation alone, were diagnosed as having LCL, with the duration of the lesions varying from 2 to 5 years. Most (85.8%) of the subjects with LCL were <20 years of age. No amastigote was found in direct smears. Moreover, direct PCR on the negative smears for identifying Leishmania provided a specificity of 100%, and the species was identified as Leishmania tropica using specific kDNA PCR. Performing PCR on skin smears appears to offer a valuable method for the diagnosis of LCL because it is highly specific and sensitive, especially for clinical correlative studies. Keywords: Lupoid cutaneous leishmaniasis, Specific kDNA PCR, Leishmania tropica, Afghanista

Exploring the diversity of uncommon oral yeast species and associated risk factors among substance abusers in southwestern Iran

Abstract Yeast species are a group of coexistent microorganisms in the oral cavity that can cause opportunistic infections in vulnerable individuals, including addicts. This study aimed to identify the yeast species profile responsible for oral yeast colonization (OYC) and the associated risk factors in patients with substance use disorder (SUD) in Ahvaz, Iran. Oral samples were collected from drug users hospitalized in 12 addiction treatment centers, and the related clinical information was mined. Oral yeast species were identified using 21-plex PCR and sequencing of the internal transcribed spacer region (ITS1-5.8S-ITS2). A total of 244 yeast strains were identified from 245 individuals with substance abuse. Candida albicans was the most common species (37.7%) and non-albicans Candida was responsible for 57.7% of OYC, primarily C. dubliniensis (33.2%) and C. glabrata (11.9%). Moreover, uncommon oral yeasts constituted 5.3% of species, including Saccharomyces cerevisiae, Clavispora lusitaniae, Pichia kluyveri, Geotrichum candidum, Magnusiomyces capitatus, Hanseniospora opuntiae, Wickerhamomyces subpelliculosus, Trichosporon asahii, and Aureobasidium pullulans. Importantly, OYC exhibited associations with such factors as duration of drug use, daily drug consumption rate, opioid utilization, oral drug administration, and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) score. The present study is the pioneering investigation revealing the prevalence and diversity of oral yeast species, along with associated risk factors, in individuals with SUD in southwestern Iran. Furthermore, it underscores the importance of developing efficient and cost-effective diagnostic methods tailored for resource-constrained settings

Investigate the Effect of Age, Sex, and Refractive Errors on the Central Thickness of the Cornea in Ophthalmology Centers in Jiroft City : association between age, sex, and refractive errors with the central thickness of the cornea

Background: The central thickness of the cornea, as one of the parameters of the anterior segment of the eye, is one of the important factors in the evaluation of patients with eye disorders.&nbsp; Material and methods: This cross-sectional study was conducted by census method in the summer of 1400 on 255 patients referred to Jiroft ophthalmology centers. Data were collected using a researcher-made checklist and analyzed using SPSS version 22 statistical software and Student's t-tests, one-way analysis of variance, and Pearson's correlation coefficient at a significance level of P &lt; 0.05. Results: 159 people (62.3 %) of the participants were women, and the average age of all people was 34.99 ± 7.33 years. The average central thickness of the cornea in the right eye in the three myopic, binocular and emmetropic groups was 501.93, 519.76, and 512.10, respectively, with the highest average central corneal thickness scores corresponding to the binocular group and the lowest average central thickness scores. The cornea of ​​the myopic group is observed and the results of the analysis of variance showed that there is a statistically significant difference between the three groups in terms of the average scores obtained (P &lt; 0.001). Conclusion: This study showed that age, gender, and refractive errors had a significant effect on the central thickness of the cornea in ophthalmology centers of Jiroft city, and there was a wide range of central corneal thickness values ​​with normal distribution

Bayesian Spatial Survival Analysis of Duration to Cure among New Smear-Positive Pulmonary Tuberculosis (PTB) Patients in Iran, during 2011–2018

Mycobacterium tuberculosis is the causative agent of tuberculosis (TB), and pulmonary TB is the most prevalent form of the disease worldwide. One of the most concrete actions to ensure an effective TB control program is monitoring TB treatment outcomes, particularly duration to cure; but, there is no strong evidence in this respect. Thus, the primary aim of this study was to examine the possible spatial variations of duration to cure and its associated factors in Iran using the Bayesian spatial survival model. All new smear-positive PTB patients have diagnosed from March 2011 to March 2018 were included in the study. Out of 34,744 patients, 27,752 (79.90%) patients cured and 6992 (20.10%) cases were censored. For inferential purposes, the Markov chain Monte Carlo algorithms are applied in a Bayesian framework. According to the Bayesian estimates of the regression parameters in the proposed model, a Bayesian spatial log-logistic model, the variables gender (male vs. female, TR = 1.09), altitude (&gt;750 m vs. &le;750 m, TR = 1.05), bacilli density in initial smear (3+ and 2+ vs. 1&ndash;9 Basil &amp; 1+, TR = 1.09 and TR = 1.02, respectively), delayed diagnosis (&gt;3 months vs. &lt;1 month, TR = 1.02), nationality (Iranian vs. other, TR = 1.02), and location (urban vs. rural, TR = 1.02) had a significant influence on prolonging the duration to cure. Indeed, pretreatment weight (TR = 0.99) was substantially associated with shorter duration to cure. In summary, the spatial log-logistic model with convolution prior represented a better performance to analyze the duration to cure of PTB patients. Also, our results provide valuable information on critical determinants of duration to cure. Prolonged duration to cure was observed in provinces with low TB incidence and high average altitude as well. Accordingly, it is essential to pay a special attention to such provinces and monitor them carefully to reduce the duration to cure while maintaining a focus on high-risk provinces in terms of TB prevalence

Exosomes derived from human placental mesenchymal stem cells in combination with hyperbaric oxygen synergically alleviates spinal cord ischemia-reperfusion injury

Spinal cord ischemia-reperfusion injury (IR) is a terrible non-traumatic injury that occurs after abdominal aortic occlusion and causes serious damage to neurological function. Several treatment strategies have been suggested for IR, but they were not unable to effectively improve these conditions. Herein we investigated whether exosomes derived from human placental mesenchymal stem cells (hpMSCs-Exos) in combination with hyperbaric oxygen (HBO) could alleviate injury and promote recovery in IR rats. Eighty male Sprague-Dawley rats were randomly allocated into five equal groups. In addition to the control group that only underwent laparotomy, IR animals were planned into four groups as follows: IR group; IR-Exos group; IR-HBO group; and IR-Exos + HBO group. Neurological function evaluated before, 6 h, 12 h, 24 h, and 48 h after injury. After the last neurological evaluation, tissue samples were obtained for stereological, biochemical, and molecular assessments. Our results indicated that the neurological function scores (MDI), the numerical density of neurons, the levels of antioxidative factors (GSH, SOD, and CAT), and anti-inflammatory cytokine (IL-10) were considerably greater in treatment groups than in the IR group, and these changes were more obvious in the IR-Exos + HBO ones. This is while the numerical density of glial cells, the levels of an oxidative factor (MDA) and inflammatory cytokines (IL-1β, TNF-α, and IL-18), as well as the expression of an apoptotic protein (caspase-3) were meaningfully decreased in treatment groups, especially IR-Exos + HBO group, compared to the IR group. Generally, it was found that co-administration of hpMSCs-Exos and HBO has synergistic neuroprotective effects in the rats undergoing IR

Prediction of type 2 diabetes mellitus using hematological factors based on machine learning approaches: a cohort study analysis

Abstract Type 2 Diabetes Mellitus (T2DM) is a significant public health problem globally. The diagnosis and management of diabetes are critical to reduce the diabetes complications including cardiovascular disease and cancer. This study was designed to assess the potential association between T2DM and routinely measured hematological parameters. This study was a subsample of 9000 adults aged 35–65 years recruited as part of Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study. Machine learning techniques including logistic regression (LR), decision tree (DT) and bootstrap forest (BF) algorithms were applied to analyze data. All data analyses were performed using SPSS version 22 and SAS JMP Pro version 13 at a significant level of 0.05. Based on the performance indices, the BF model gave high accuracy, precision, specificity, and AUC. Previous studies suggested the positive relationship of triglyceride-glucose (TyG) index with T2DM, so we considered the association of TyG index with hematological factors. We found this association was aligned with their results regarding T2DM, except MCHC. The most effective factors in the BF model were age and WBC (white blood cell). The BF model represented a better performance to predict T2DM. Our model provides valuable information to predict T2DM like age and WBC