Epidemiology of Poisoning in Northeast of Iran (2004-2013)

Background: Poisoning is a major concern, especially in developing countries. We aimed to focus on poisoning trends based on registry data for the recent 10 years.Methods: This cross-sectional study was performed on registry database of Imam Reza Hospital in Mashhad, Iran. All cases of toxic exposure or poisoning during 2004 to 2013 were included (49189 patients). Data from two national censuses were used for calculating rates. SPSS 11.5 was used for data analysis. P<0.05 was considered statistically significant.Results: There were 49189 admissions during the 10-year period with a mean age of 26.21±14.97 years out of which 50.3% were female. The prevalence rate had increased three times in women and four times in men. Pharmaceutical toxins (63.5%) had the highest proportional mortality ratio, which mostly occurred in winters. The mean age of admission began to decline again in recent years.Conclusion: Analyzing data on secular trends can always enlighten the healthcare decision makers for real health problems. Designing the proper population-based interventions can be one of the many uses of these findings

Relationship between household food insecurity and food and nutrition literacy among children of 9-12 years of age: a cross-sectional study in a city of Iran

Objective: The aim of this study was to assess the relationship between household food insecurity (HFI) with food and nutrition literacy (FNLIT) in a sample of Iranian children. This cross sectional study was performed on 315 children aged 9 to 12 years recruited from the primary schools throughout Mashhad, Iran. The Household Food Insecurity Access Scale (HFIAS) was used to assess the HFI. Also, overall FNLIT score and its sub-categories were evaluated using a validated 40-item questionnaire. Results: The prevalence of HFI in the total sample was about 56. Also, almost 14 of students had a low FNLIT score. Food insecure children had significantly lower levels of FNLT and some subscales including nutrition knowledge, food choice literacy, and food label literacy than the food-secure subjects, moreover, they had a higher likelihood of having low FNLIT score (OR = 2.89, CI 1.03-8.09; p = 0.04). In conclusion, there is a negative association between HFI and FNLIT in children. Further studies to confirm this finding are needed. © 2020 The Author(s)

Effect of changing journal clubs from traditional method to evidence-based method on psychiatry residents

Farhad Faridhosseini,1 Ali Saghebi,2 Majid Khadem-Rezaiyan,3 Fatemeh Moharari,2 Maliheh Dadgarmoghaddam3 1Psychiatry and Behavioral Sciences Research Center, 2Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, 3Community Medicine, Faculty of Medicine, Mahhad University of Medical Sciences, Mashhad, Iran Introduction: Journal club is a valuable educational tool in the medical field. This method follows different goals. This study aims to investigate the effect on psychiatry residents of changing journal clubs from the traditional method to the evidence-based method. Method: This study was conducted using a before–after design. First- and second-year residents of psychiatry were included in the study. First, the status quo was evaluated by standardized questionnaire regarding the effect of journal club. Then, ten sessions were held to familiarize the residents with the concept of journal club. After that, evidence-based journal club sessions were held. The questionnaire was given to the residents again after the final session. Data were analyzed through descriptive statistics (frequency and percentage frequency, mean and standard deviation), and analytic statistics (paired t-test) using SPSS 22. Results: Of a total of 20 first- and second-year residents of psychiatry, the data of 18 residents were finally analyzed. Most of the subjects (17 [93.7%]) were females. The mean overall score before and after the intervention was 1.83±0.45 and 2.85±0.57, respectively, which showed a significant increase (P<0.001). Conclusion: Moving toward evidence-based journal clubs seems like an appropriate measure to reach the goals set by this educational tool. Keywords: journal club, evidence-based, residents, education metho

The Role of Lipid Profile as an Independent Predictor of Non-alcoholic Steatosis and Steatohepatitis in Morbidly Obese Patients

Background and Aims: Obesity is one of the major health problems worldwide. Morbid obesity (body mass index >40 kg/m2 or over 35 with a comorbidity) is associated, apart from other diseases, with an increased risk of non-alcoholic fatty liver disease (NAFLD). Moreover, dyslipidemia is an important comorbidity that is frequently found in NAFLD patients. The aim of this study was to analyze whether serum lipids in morbidly obese patients are associated with the spectrum of NAFLD. ----- Methods: Total serum cholesterol, LDL cholesterol, HDL cholesterol, non-HDL cholesterol, VLDL, and triglycerides were analyzed in 90 morbidly obese patients. The association of lipid profile parameters with histopathological, elastographic, and sonographic indices of NAFLD, non-alcoholic steatohepatitis (NASH), and liver fibrosis were explored. ----- Results: The mean levels of serum total cholesterol, LDL-C, and non-HDL cholesterol in patients with positive histology for liver steatosis and NASH were significantly higher than those in patients with negative histology. None of the indices showed a strong association with NAFLD, NASH, or liver fibrosis after adjustment for potential confounders. ----- Conclusion: A slight predictive value of lipid profile is not sufficiently enough to use solely as a non-invasive test in predicting NASH or liver fibrosis

Nutritional adequacy in critically ill patients: Result of PNSI study

Background & aims: Critically ill patients are provided with the intensive care medicine to prevent further complications, including malnutrition, disease progression, and even death. This study was intended to assess nutritional support and its' efficacy in the Intensive Care Units (ICUs) of Iran. Methods: This cross-sectional study assessed 50 ICU's patients out of 25 hospitals in the 10 major regions of Iran's health system and was performed using the multistage cluster sampling design. The data were collected from patient's medical records, ICU nursing sheets, patients or their relatives from 2017 to 2018. Nutritional status was investigated by modified NUTRIC score and food frequency checklist. Results: This study included 1321 ICU patients with the mean age of 54.8 ± 19.97 years, mean mNUTRIC score of 3.4 ± 2.14, and malnutrition rate of 32.6. The mean time of first feeding was the second day and most of patients (66) received nutrition support, mainly through enteral (57.2) or oral (37) route during ICU stay. The patients received 59.2 ± 37.78 percent of required calorie and 55.5 ± 30.04 percent of required protein. Adequate intake of energy and protein was provided for 16.2 and 10.7 of the patients, respectively. The result of regression analysis showed that the odds ratio of mNUTRIC score was 0.85 (95 confidence interval CI = 0.74�0.98) and APACHE II was 0.92 (95%CI = 0.89�0.95) for the prediction of energy deficiency. Nutrition intake was significantly different from patient's nutritional requirements both in terms of energy (p < 0.001) and protein (p < 0.001). Also, mean mNUTRIC score varied notably (p = 0.011) with changing in energy intake, defined as underfeeding, adequate feeding, and overfeeding. Conclusion: The present findings shown that, provided nutritional care for ICU patients is not adequate for their requirements and nutritional status. © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolis