Comparison of serum levels of thyroidstimulating hormone in preeclampsia and non-preeclampsia pregnant women referring to Karaj Kamali Hospital in 2018

Introduction: As there is no reliable criterion for early diagnosisof preeclampsia up to present date, this study wasconducted to compare the serum levels of thyroid-stimulatinghormone in preeclampsia and non-preeclampsiapregnant women and the use of thyroid-stimulating hormone(TSH) as a predictive factor in preeclampsia.Method: In this case-control study, 45 non-preeclampsiapregnant women and 45 preeclampsia pregnant womenin the third trimester of pregnancy referred to Kamali Hospitalof Karaj were examined. A skilled person took 10 ccof venous blood of the subjects and the mean serum TSHlevels of both groups were compared by using SPSS, version22, software.Results: The mean serum TSH level was 2.55 ± 1.13 and3.08 ± 1.23, respectively, in non-preeclampsia pregnantwomen and preeclampsia pregnant women, the relationshipwas statistically significant (P =0.013). Besides, theprevalence of preterm delivery in preeclampsia pregnantwomen was higher than that in non-preeclampsia pregnantwomen (P = .000). The mean weight of neonatesin preeclampsia pregnant women was lower than that innon- preeclampsia pregnant women (P = .000).Conclusion: This study revealed that measuring serumTSH levels in the third trimester of pregnancy could be apredictor of preeclampsia

Prevalence of Mycoplasma genitalium and Mycoplasma hominis isolates among Women with Cervicitis Referred to Karaj Health Care Centers

Background and Objectives: Mycoplasma is a genus of bacteria often found in the normal flora of the mouth, respiratory system and urogenital tract; but potentially pathogenic species also exist which can cause serious respiratory and genital diseases in human including postpartum fever, pelvic inflammatory infections, and pyelonephritis. The aim of this study was to evaluate the prevalence of Mycoplasma genitalium and Mycoplasma hominis in women who referred to the health centers in Karaj and investigate the susceptibility of M. genitalium strains against Fluoroquinolone antibiotics.Materials & Methods: Endocervical swabs were taken from 200 women with cervicitis. Nucleic Acid Amplification Tests (NAATs) were performed for detecting Mgpa gene in M. genitalium and RNH gene in M. hominis. Mutations in parC and gyrA genes, as well as antibiotic resistance, were studied in positive samples of M. genitalium.Results: 9 M. genitalium and 11 M. hominis positive samples were found among samples obtained from women with cervicitis. Positive samples of M.genitalium were examined for isolating the parC and gyrA genes. Six sequences of these genes were analyzed by MEGA5 software. Mutation in parC gene was observed in one sequence which %16 shows resistance.Conclusion: M. hominis and M. genitalium were detected in 5.5% and 4.5% of samples, respectively. Our findings showed a relatively medium prevalence of M. hominis and M. genitalium in women with cervicitis in Alborz province. The sequencing results of gyrA and parC genes in this study represent the occurrence of mutations which drive fluoroquinolones resistance. Therefore, further studies are necessary in this area and to overcome this problem irregular prescribing limited and antibiotic sensitivity patterns in treatment to be considered

Substance abuse behaviors among university freshmen in Iran: a latent class analysis

OBJECTIVES Substance abuse behaviors among university freshmen in Iran are poorly understood. This study aimed to identify, for the first time, subgroups of university freshmen in Iran on the basis of substance abuse behaviors. Moreover, it examined the effects of socio-demographic characteristics on membership in each specific subgroup. METHODS Data for the study were collected cross-sectionally in December 2013 and January 2014 from 4 major cities in Iran: Tabriz, Qazvin, Karaj, and Khoramabad. A total of 5,252 first-semester freshmen were randomly selected using a proportional cluster sampling methodology. A survey questionnaire was used to collect data. Latent class analysis (LCA) was performed to identify subgroups of students on the basis of substance abuse behaviors and to examine the effects of students’ socio-demographic characteristics on membership in each specific subgroup. RESULTS The LCA procedure identified 3 latent classes: the healthy group; the hookah experimenter group; and the unhealthy group. Approximately 82.8, 16.1, and 2.1% of students were classified into the healthy, hookah experimenter, and unhealthy groups, respectively. Older age, being male, and having a family member or a close friend who smoked increased the risk of membership in classes 2 and 3, compared to class 1. CONCLUSIONS Approximately 2.1% of freshmen exhibited unhealthy substance abuse behaviors. In addition, we found that older age, being male, and having a close friend or family member who smoked may serve as risk factors for substance abuse behaviors

High frequency of methicillin-resistant Staphylococcus aureus (MRSA) with SCCmec type III and spa type t030 in Karaj’s teaching hospitals, Iran

Methicillin-resistant Staphylococcus aureus (MRSA) has been one of the most important antibiotic-resistant pathogen in many parts of the world over the past decades. This cross-sectional study was conducted to investigate MRSA isolated between July 2013 and July 2014 in Karaj, Iran. All tested isolates were collected in teaching hospitals from personnel, patients, and surfaces and each MRSA was analyzed by SCCmec and spa typing. Antibiotic susceptibility testing was accomplished by disk diffusion method. Out of 49 MRSA isolates from the Karaj’s teaching hospitals, 82%, 10%, and 6% of the isolates were SCCmec types III, II, and I, respectively. The main spa type in this study was spa t030 with frequency as high as 75.5% from intensive care unit (ICU) of the hospitals and high rate of resistance to rifampicin (53%) was found in MRSA isolates. In conclusion, high frequency of spa t030 with SCCmec type III and MRSA phenotype illustrated circulating of one of the antibiotic-resistant strains in ICU of Karaj’s teaching hospitals and emphasizes the need for ongoing molecular surveillance, antibiotic susceptibility monitoring, and infection control

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. Methods We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. Findings Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. Interpretation As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. Funding Bill & Melinda Gates Foundation

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Pathways of job style and preterm low birth weight

Introduction: Preterm and low birth weight tend to occur as a direct result of prenatal risky behaviors, diseases, as well as fetal exposure to harmful social and environmental factors. The present study aimed to investigate the relationship between job style and preterm low birth weight. Methods: The present case-control study was conducted in the Kamali hospital, Teheran, Iran in 2014. Participants included 156 mothers having a gestational age of less than 37 weeks and infants weighing less than 2500 gm. Additionally, the control group consisted of 433 mothers with a gestational age of over 37 weeks and having infants weighing between 2500-4000 gm. The data were collected using the Mother's Lifestyle Scale (MLS) during pregnancy based on recognized social determinants of health and those developed by the researchers. The domain of the mother's job style was assessed using a questionnaire consisting of 18 items on topics such as working conditions, job satisfaction, and perceived employer empathy. Higher overall scores in this instrument indicate the mother’s poorer job style. The data were analyzed using SPSS version 16 and Lisrel version 8.8 through a statistical path analysis. Results: The model fit indices indicated that there was found to be high favorability, demonstrated that the model fit and that there were rational relationships (CFI=1, RMSEA=0.00), and showed that on the direct path that the mother's job style had the most adverse effect (B=-0.3) with weight gain during pregnancy showing the most positive effect (B=0.16) on PLBW. The mother’s level of education was found to be the only variable that affected PLBW negatively in both the direct and indirect paths through the mother's job style and household income (B=-0.17). Conclusion: According the path analysis model, job style has a direct influence on preterm low birth weight. Thus, special consideration should be placed on aspects surrounding a mother’s job situation in order to prevent any adverse effects

Patient Experiences of Hospital Stay in Alborz Governmental Hospitals

Background and Aims: Attaining the patients' viewpoints and evaluating their experiences are reliable and important resources for determining the problems and appraising healthcare improvement. This study aimed to investigate the experiences of patients who hospitalized in hospitals of Alborz province. Materials and Methods: In this descriptive cross-sectional study 955 patients discharged from nine governmental hospitals were selected by stratified random sampling method and participated in this study. The questionnaire that its validity and reliability had been confirmed was used to assess patients' experiences of hospital stay. Results: More than half of the participants (56.4%) were female. The most frequent age group (34.3%) was the age group of 20 to 30 years. 45.4% of patients experienced a perfect organization in reception sector in emergency ward, and 42.5% of patients experienced a perfect organization in reception sector of non-emergency wards. In sum, 79.4% of patients assessed the hospital healthcare services in good level (or higher) and 35.9% stated that they would recommend the hospital to others. Conclusion: The results indicates the need for designing and implementing the programs to improve patients' experiences in the areas of reception and discharge sectors organization, physical environment and facilities, communication with doctors and nurses, respectfulness, through training and empowerment of staff of hospitals and improving the existing infrastructure in the hospital

The effect of a health literacy approach to counselling on the lifestyle of women with gestational diabetes: A clinical trial [version 1; referees: 2 approved]

Background: Gestational diabetes is a common pregnancy disorder that affects the mother’s and neonate’s health. The present study was conducted to investigate the effect of a health literacy approach to counselling on the lifestyle of women with gestational diabetes. The present randomized controlled clinical trial was conducted in 2017 using a parallel design. The subjects included 84 eligible women presenting to Alborz and Kamali Hospitals, Karaj, Iran. Methods: Convenience sampling was first used to select the subjects. They were then assigned to an intervention or control group based on randomized blocks of four. Both groups attended counselling sessions. The mothers in the intervention group attended six sessions of counselling with a health literacy approach in addition to counselling on routine pregnancy care. The control group attended counselling sessions on safe pregnancy care and received a training package containing all the subjects discussed in the intervention group. The Lifestyle Questionnaire and the Iranian Health Literacy Questionnaire were completed by the mothers at the beginning and at the end of the sessions as well as three weeks after the sessions. The data obtained were analyzed in SPSS-19. Results: According to the study findings, the scores of lifestyle (P=0.8) and health literacy (P=0.423) showed no significant differences between the intervention and control groups before the intervention. Significant differences were, however, observed in the mean scores of lifestyle and health literacy between the two groups immediately and three weeks after the intervention. Comparing the means showed a higher increase in the mean scores in the intervention group (P<0.001). Conclusions: Providing counselling services by midwives can significantly help modify mothers’ unhealthy lifestyle choices and increase their health literacy; therefore, reducing maternal and neonatal consequences, especially in high-risk pregnancies. Trial registration number: IRCT2017021427728N3 Trial registry: Iranian Registry of Clinical Trials Trial registration date: 5th April 201

Comparison of the Effect of Area and Capacity of Swimming Pools on the Coliforms and Heterotrophic Contamination

Background& Objective: Swimming is great exercise and entertainment and enjoyment for people of all ages, especially in the hot season. Due to health issues and ways to ensure the health and welfare of people, swimming pools are very important. Therefore, in this study, relationship between the capacity and area of the pool with microbial contamination and heterotrophs were investigated. Materials and Methods: This study, based on applied research and analytical - descriptive, correlational, cross-sectional survey was conducted. In this project, we studied 35 swimming pools in the city of Karaj. For this purpose, samples were collected every month for 9 months, turbidity, pH, free residual chlorine was measured at the sampling time and testing for total coliform, E.coli coliform and counting of hetrotrophic organisms in the laboratory of water and wastewater was performed. Data was analyzed by using SPSS software and peyerson analytical. Results: Frome the 315 coliform samples about 90.2% was pure. Of the 315 tested HPCs, 99.7 percent was found in the clean range. The minimum HPC reported is zero, at most 250 with an average of 18/11 and a standard deviation of 266.68. Peyerson correlation test between heterotrophic bacteria with water turbidity and area to swimmer also has a significant relationship. In this study, there was no significant relationship between swimming pool pollution with pool area. Conclusion: According to the results, observance of the sanitary regulations of the pool and technical issues can be effective in reducing microbial and heterotrophs contaminatio