Study of Status Anxiety among Librarians of Central Libraries of Public Universities in Tehran

Objective: The purpose of this research is to investigate the status anxiety and its dimensions among librarians of central libraries of public universities in Tehran. Methodology: This research is an applied and survey research. The research sample was the librarians of central libraries of public universities in Tehran of Tehran. A questionnaire was used to collect the data, which includes 65 questions under three individual, organizational, and socio-cultural dimensions. Descriptive and inferential statistics including Friedman test, independent t test, F test, and Pearson correlation test were used to describe and analyze the data. Findings: The findings showed that the level of status anxiety in terms of the individual dimension is higher than the organizational and socio-cultural dimensions. The average of status anxiety is high in the individual dimension and moderate in the organizational and socio-cultural dimensions. In addition, there is no significant difference in the level of status anxiety in terms of gender, age, and professional experience of librarians, and dignity anxiety is experienced by all librarians of central libraries of public universities in Tehran. Conclusion: Since the librarians of university libraries are part of the official system of university education and research and deal with a diverse range of students in different fields, it is desirable to reduce the status anxiety in their profession and to create a sense of value and self-confidence in them. Training librarians to manage their anxiety, providing fair wages and welfare for librarians as best as possible, and introducing the values of the librarianship profession through mass media and social networks, can help to increase self-confidence and reduce the status anxiety of librarians from the individual, organizational, and socio-cultural point of view

The Effect of Adding Low-Dose Naloxone to Intrathecal Morphine on Postoperative Pain and Morphine Related Side Effects after Cesarean Section: A Double-Blind, Randomized, Clinical Trial

BACKGROUND: Nowadays, spinal anaesthesia is a suitable choice for most elective and emergency cesarean section (C-section) deliveries. AIM: This study aimed to determine the effect of adding low-dose naloxone to intrathecal morphine on postoperative pain and morphine related side effects after C-section. MATERIAL AND METHODS: In the present double-blind, randomised clinical trial, 70 women aged over 18 years, who were candidates for elective medical C-section under spinal anaesthesia were selected and randomly assigned to either the study group or the control group. For spinal anaesthesia, 10 mg of Bupivacaine plus 100 μg of morphine was administered for all patients. However, patients in the study group received 20 µg of naloxone intrathecally; but the patients in the control group only received normal saline as a placebo. After surgery, patient-controlled analgesia (PCA) pump with paracetamol (Apotel®) was connected to each patient. The intensity of postoperative pain in the patients was evaluated and recorded using Visual Acuity Screening (VAS) at 2, 4, 6 and 24 hours after the surgery. The patients were also examined for postoperative nausea and pruritus. RESULTS: Regardless of the groups to which the patients were assigned, a significant difference in pain intensity was observed during the study period (time effect; p < 0.001). Although the intensity of pain was lower in the study group, the difference was not statistically significant (group effect; p = 0.84). Also, there was no group time interaction between pain intensity and the times studied (p = 0.61). The incidence rates of postoperative nausea and pruritus were significantly lower in the study group compared to the control group (p < 0.001). CONCLUSION: According to the results of this study, adding low dose naloxone to intrathecal morphine did not significantly change postoperative pain intensity in the patients undergone elective C-section using spinal anaesthesia; however, significantly decreased the severity of postoperative nausea and pruritus

Survey of Views of Medical Students on Telemedicine Methods Developed in the Mazandaran University of Medical Sciences, Iran

Background & Objective: Telemedicine is the use of new communication and information technologies to provide clinical services, health care, and transferring of information for care of patients from a geographical distance. The aim of this research was to determine the views of medical students on the development of telemedicine procedures in the Mazandaran University of Medical Sciences, Iran. Methods: A sample of 90 medical students was selected randomly in the first semester of study of 2011-12. The student's views were assessed using a questionnaire of 33 questions consisting of three parts: demographic data, questions in five areas (organizational factors, technological factors, stakeholders, agents, information literacy, and environmental factors), and student use of the various areas of technology (computers, internet, medical websites, medical applications, and etc.) Results: In the questions concerning the scope of the organizational factors 65.5% of students had a positive opinion in regard to "admission to the structural changes in the organization". Among the factors of technology 86.7% of students had positive views on "broadband access", in the factors of stakeholders 58.9% on "empowering the private sector in implementing telemedicine", in the information literacy 75.5% on "students' skills in using computers and the Internet", and in the environmental factors 80.0% on "economic factors for the plan". Conclusion: Students believed the role of economic factors (cost, appropriate technology, and etc.) to be more important than cultural factors (physician-patient interaction, culture, community support, willingness of the family, and etcetera). Keywords Vision Telemedicine Mazandaran University of Medical Sciences Ira

Investigating the relationship between carotid intima-media thickness, flow-mediated dilatation in brachial artery and nuclear heart scan in patients with rheumatoid arthritis for evaluation of asymptomatic cardiac ischemia and atherosclerotic changes

Background: Cardiovascular disease is the most common cause of death worldwide. In order to prevent and treat heart diseases, we need to estimate the trend of non-cardiac diseases with the cardiovascular system. Arthritis Rheumatoid is a chronic immune/inflammatory process which leads to subclinical atherosclerosis and increases cardiovascular disease. We examined the patients who referred to our nuclear medicine center for MPI and correlated their findings with flow-mediated dilatation (FMD) of the brachial artery and carotid intima-media thickness (CIMT) in arthritis rheumatoid patients. Material and methods: A total 30 known cases with arthritis rheumatoid were referred to our department for MPI and the single-photon emission computed tomography (SPECT) imaging were visually and quantitatively evaluated by two nuclear medicine physicians and the correlation of the measured FMD and CIMT were evaluated and compared with ultrasonography data. Demographic information such as gender, age and sex and medical history (risk factors, cardiovascular sign and symptoms, lab findings, medication etc…) were recorded in questionnaire sheets and were analyzed by SPSS.20. Chi-square and student t-test were used for further analysis. Results: The mean CIMT (R = 0.452 ± 0.07, L = 0.447 ± 0.08) and %FMD (R = 7.22 ± 8.66, L = 6.42 ± 11.88) were measured for all subjects. Age was the only parameter correlated with both right and left CIMT (P = 0.033 and P = 0.024, respectively). Among the patients, 26.7% had mild ischemia (SSS < 8) and 3 of them suffered from active arthritis rheumatoid. All patients with RA showed normal ventricular ejection fraction and normal volumes and among them, 93.3% had normal functional performance (normal wall motion…). Moreover, the mean CIMT and %FMD were not significantly different in ischemic and non-ischemic patients. Among ischemic patients, just the course of the disease was associated with CIMT and none of the parameters was correlated with FMD. Conclusions: There is no significant statistical difference between ischemic and non-ischemic patients and also the functional performance with values of CIMT and FMD. Among all populations, the parameter of age, and in ischemic group, the course of disease were found as the only variable correlated with CIMT

The Comparison of Pain Caused by Suprapubic Aspiration and Transurethral Catheterization Methods for Sterile Urine Collection in Neonates: A Randomized Controlled Study

This study was performed to compare the levels of pain experienced by young infants undergoing either suprapubic aspiration (SPA) or transurethral catheterization (TUC) for the collection of sterile urine samples. This prospective randomized clinical trial was conducted in hospitalized neonates in a university-affiliated hospital. Patients who required urine cultures were randomly assigned into one of two groups, the SPA or TUC group. The infants’ faces were videotaped, and the changes in the facial expression and physiological parameters during the procedure were scored using the Premature Infant Pain Profile (PIPP) in a blind manner. The primary outcome was the severity of the pain experienced during each procedure, and the secondary outcomes were the success rate, the duration, and the complications of each procedure. Ninety-four percent of male infants in the TUC group and 77.3% in the SPA group were uncircumcised (P=0.1). The mean (SD) of the PIPP pain scores did not differ between groups (9.95 ± 3.7 in SPA and 9.64 ± 3.2 in TUC, P=0.6). The duration of TUC was longer. Both methods can be used to collect urine from neonates, but the difficulty of performing TUC on females and uncircumcised males should be considered

Depression and Anxiety Disorders among Patients with Psoriasis: A Hospital-Based Case-Control Study

Background. Psoriasis is a common, genetically determined inflammatory and proliferative disease of the skin. Psychological stress can exacerbate the disease. This study sought to investigate the depression and anxiety disorders among patients with psoriasis and control group. Method. In this hospital-based case-control study, One hundred patients with psoriasis (case) referred to the dermatology department and 100 patients with otolaryngology problems and dermatological healthy volunteers (control) who referred to the Otolaryngology Department of Bouali Sina Hospital in Sari, Iran, in 2007 were studied. Demographic characteristics were recorded. Beck Depression Inventory and Spielberger State-Trait Anxiety Scale I-II were administered to the patients in both groups. Data were analyzed using SPSS statistical software and descriptive statistical tests. Results. From One-hundred patients in each group, 44 (45%) were men. Depression score was 67% and 12% in psoriatic patients and control, respectively. The Beck depression scores of patients with psoriasis were significantly higher than scores of the control group (<0.05). Based on Spielberger State-Trait Anxiety Scale, anxiety was found in 45% of patients in case group and 18% of controls. Conclusion. The results revealed that psoriatic patients reported significantly higher degrees of depression and anxiety than controls. In addition, psoriatic women were more depressed than psoriatic men

Does high-dose metformin cause lactic acidosis in type 2 diabetic patients after CABG surgery? A double blind randomized clinical trial

Metformin is a dimethyl biguanide oral anti-hyperglycemic agent. Lactic acidosis due to metformin is a fatal metabolic condition that limits its use in patients in poor clinical condition, consequently reducing the number of patients who benefit from this medication. In a double blind randomized clinical trial, we investigated 200 type 2 diabetic patients after coronary artery bypass surgery in the open heart ICU of the Mazandaran Heart Center, and randomly assigned them to equal intervention and control groups. The intervention group received regular insulin infusion along with 2 metformin 500 mg tablets every twelve hours, while the control group received only intravenous insulin with 2 placebo tablets every twelve hours. Lactate level, pH, base excess, blood glucose and serum creatinine were measured over five 12 h periods, with data averaged for each period. The primary outcome in this study was high lactate levels. Comparison between the 2 groups was made by independent Student’s t-test. To compare changes in multiple measures in each group and analysis of group interaction, a repeated measurement ANOVA test was used

Identification of Pathogens in Nasopharyngeal Secretions of Patients with and without Pneumonia by Multiplex RT-PCR Method

Background and purpose: Pneumonia is the most common infectious cause of death. This study aimed at investigating the causative agent of pneumonia in nasopharyngeal secretions by PCR method. Materials and methods: This case-control study was carried out in patients (older than 19 years of age) suspected of pneumonia admitted to Qaemshahr Razi Hospital and Sari Imam Khomeini Hospital, Iran 2019. The control group included inpatient and outpatient cases with non-respiratory diseases. The case group included patients who met the clinical and radiological criteria. FTD respiratory pathogens 21 plus kit (Multiplex RT-PCR) was used which covers a significant number of microorganisms. Data were analyzed in SPSS V18. Results: The study included 60 patients with the mean age of 52.13±16.84 years (19-87 years old) and the mean age of the control group was 47.8±16.63 years (21-83 years old). Etiological agents were significantly different between the two groups (P<0.05). According to PCR results, the prevalence of viral and bacterial etiology was 56.7% and 26.7%, respectively, and in 16.7% the PCR was negative. Conclusion: Multiplex RT-PCR is associated with great specificity and specificity and is easily performed.  The assay is not low cost but is of great benefit in detecting causative agents and avoiding inappropriate treatments and can reduce further bacterial resistance

Single Surgeon Experience of Adjacent Segment Disease and Related Risk Factors Following Posterior Decompression and Fusion in Lumbar Degenerative Disorders

Background and Aim: This study aims to evaluate the frequency of adjacent segment disease (ASD) and its risk factors following posterior decompression and fusion in lumbar degenerative disorders. Methods and Materials/Patients: This retrospective cohort study was performed by reviewing the records of patients with spinal degeneration disorders who underwent lumbar fusion surgery and needed reoperation from 2013 to 2019. The participants were divided into two groups, including patients with ASD and non-ASD patients, and were compared in terms of age, sex, BMI, smoking, fusion level, surgical indications, follow-up times, laminectomy, cross-link device usage, imaging findings, fusion terminating in L1, L5 and S1, and reoperation. Results: Out of a total of 277 candidates, 181 met the inclusion criteria. In terms of gender distribution, 43.3% of the participants were male and 56.7% were female. The median age was 54 years in the ASD group and 48 years in the non-ASD group. The median follow-up of the patients was six years in the ASD group and five years in the non-ASD group. Forty patients (22.1%) developed ASD during this period. The final analysis showed a significant relationship between age, sex, indication for reoperation, repeated surgery, laminectomy, cross-link device use, imaging findings, and fusion terminating in L1. Conclusion: High body mass index, aging, lumbar spinal canal stenosis, reoperation, laminectomy at the upper fusion unit, cross-link device use, lumbar canal stenosis in imaging, and fusion to L1 vertebrae are considered risk factors for ASD