Assessment of unhealthy days of urban marginal inhabitants and effective factors in Mashhad, Iran

Background: The concept of the quality of life (HRQOL) related to health and its determinants contain aspects of quality of life that clearly affect people’s physical or mental health. One of the newest ways to assess the health and also the quality of life-related to health is the self-assessed health of the individual. The aim of the present study was assessment of unhealthy days, self-reported health status, and its influencing factors on residents of the marginalpart of Mashhad, Iran. Methods: In the current cross-sectional study, 580 citizens of the marginal regions and slum areas of Mashhad city were enrolled through cluster sampling method using governmental health care services divisions. The Persian version of the questionnaire CDC HRQOL-4 was used to measure the unhealthy days. Data was analyzed using SPSS, version 11.5, running ANOVA, chi-square, and t-tests. P-value of less than 0.05 was considered as statistically significant. Results: In the present study, 359 persons (61%) were women and the mean age of participants was 32.6±11.51 years. The means of unhealthy days, physically unhealthy days, mentally unhealthy days, and days with dysfunction were found to be 7.2, 2.8, 4.1, and 1.7 days, respectively. The unhealthiest days (physical and mental) were seen in unemployed people and the best to excellent health days were seen in housewives. Conclusion: Unhealthy days and days with dysfunction were reported higher in slum inhabitants, especially female, low literacy, and housewife participants. Providing the education and employment facilities for people who live in marginal city areas might decrease the unhealthy days.Keywords: Unhealthy days; Health; Urban Marginal Inhabitants; Mashha

Acute Kidney Injury in Poisoned Patients Admitted to ICU

Background: Acute Kidney Injury (AKI) is an abrupt decrease in kidney function, leading to the retention of urea and other nitrogenous waste products. Poisoned patients admitted to the Intensive Care Unit (ICU) may develop AKI due to some reasons. This study was done to evaluate the AKI in poisoned patients admitted to ICU. Methods: 146 patients, admitted to the ICU of Imam Reza Hospital from March 2017 to March 2018 were studied. AKI status was assessed using Acute Kidney Injury Network (AKIN) and Risk, Injury, Failure, Loss of kidney function and End-stage kidney disease (RIFLE) classification. Data analysis was done through SPSS V. 22 software.Results: Opioids, organophosphates, aluminum phosphide, multiple drugs, and other types of poisoning were the main five poisoning classes. Opioid toxicity was had the highest frequency with 51 patients; cases in this group experienced longer length of hospitalization stay and higher serum creatinine level than others did. Among 146 patients, 19 patients (12.8%) died, and 97 patients (66%) were transferred to the ICU. Of all cases, 18 patients (12.3%) had renal dysfunction (six patients were at risk, five patient at injury, and seven patients were at failure phase based on the RIFLE criteria). Renal replacement therapy was required in 24 cases (16.4%).Conclusion: It is unlikely to detect a significant difference in the occurrence of AKI between the main poisoning classes. Being the largest group of intoxicated patients admitted to the ICU, the opioid poisoning had the highest rate of AK

Individual and External Catalysts and Barriers of Biking: A Community Based Study in a Metropolis

Biking has proven health, environmental and traffic benefits. To prevail biking at community infrastructures and "BicycleSharing Systems (BSS)" have been developed, but their effectiveness is dependent on people's attitudes and perceptions.We aim to investigate attitudes of people toward biking and related infrastructures with regard to demographic factors inMashhad, Iran-a metropolis with unsuccessful BSS. The present work was conducted as a cross-sectional study at Mashhad,Iran, in 2015. In a multistage sampling, adult inhabitants were selected and data about their perceptions of benefits andbarriers of biking were collected through a researcher-designed questionnaire. Of 437 study participants with a mean(±SD) age of 29.9 (±11.3) years, 250 (57.3%) were female. Only 3 (0.7%) of respondents used bikes. Positive attitudeswere significantly associated with gender, marital status and occupation of participants. Car ownership was accompaniedby higher perceptions of "tiredness of biking"(p=0.02), its "low safety" (p=0.02) and "time wasting" (p=0.01). According tothe results, cultural interventions are needed for biking promotion regardless of their socioeconomic status. Educationalprograms at academic settings are also valuable. Safety, convenience, and affordability of different groups of populations(like elderly and deprived people) should be regarded during designing and constructing biking infrastructures and settingparticipation rules

Status of soluble ST2 levels in serum of HTLV-1 infected individuals

ST2 is a member of IL-1 receptor family expressed on Th2 cells and regulates Th2 responces. The gene of ST2 encodes soluble ST2 (sST2) and the transmembrane ST2 (ST2L) isoforms through alternative mRNA splicing. The discovery of IL33/ ST2 signaling pathway, has drawn a great scientific attention to this system. sST2 has been shown to be an indacating factor in various infl ammatory conditions. This study aims to evaluate serum sST2 levels in HTLV-1 infected patients. This study included 49 HTLV-1 seropositive cases of which 14 were sympthomatic. Controls consisted of 30 healthy volunteers. sST2 level was measured using a quantitative ELISA assay and the results of the study groups were compared. Corroborating the previous reports, sST2 was lower in females (P = 0.003). The sST2 levels was slightly increased in HTLV-1 patients, though such increase was not statistically significant (P = 0.91), in addition sST2 level did not correlate significantly to the disease duration (P = 0.78). Despite some other chronic viral infection, HTLV-1 seems not to induce high serum sST2. However owing to relatively high normal variation of sST2 levels and rather small sample size, we stongly recommend further reseach with preferably larger sample size to evalute sST2 in HTLV-1 infected patients

Serum vitamin C levels: a comparison between febrile children with or without seizure

Objective: An imbalance has been reported in the oxidant-antioxidant system of infants with febrile convulsion. This study aimed to compare serum vitamin C levels between febrile children with or without seizures. Materials and Method: This multicenter case-control study was conducted on febrile infants and children who were referred to the pediatric emergency wards of Mashhad University of Medical Science. The subjects were equally divided into two febrile groups of case (with seizure) and control (without seizures). Visible Spectrophotometer was used to determine the total vitamin C level.Results: In total, 100 febrile children were included in this study. Based on the results, there was no statistically significant difference between the two groups in terms of age, gender, and family history of febrile convulsion (FC) (P>0.05). The mean vitamin C levels in the case and control groups were 42.73±7.2 and 78.59±11.1 µg/l, respectively. There was a significant difference between the groups regarding the vitamin C level (P<0.001). Regression analysis revealed that age (P=0.74), gender (P=0.66), and family history of febrile convulsion (P=0.52) had not any correlation with vitamin C levels. On the other hand, the vitamin C levels was associated with FC (P=0.001).Conclusion: The serum levels of vitamin C in the children with febrile seizure were lower than those in the control group. Thus, the reduced vitamin C levels can be considered as a predisposing factor for FC

Educational Evaluation of Medical Student in Health Centers Using Portfolios: A Pilot Study

Background & Objective: The desire for portfolio application, as a suitable method for evaluation of clinical students, has recently expanded. This study investigated the implementation of portfolio in the evaluation of medical students. Methods: In the current study, medical students in their educational rotations in health centers in Mashhad, Iran, in 2011 were evaluated by using portfolio. The scores of medical students' performance and health centers supervisors' evaluation of them were assessed during 10 months and compared with scores from a similar period in the past. Data were analyzed using t-test and SPSS software. Results: Portfolios were completed by all medical students during their rotation in health centers and and evaluation of student was done based on portfolio scoring. Mean performance scores of medical students and health center supervisors' evaluation of them had increased compared of them by portfolio evaluation had increased compared with traditional students' evaluation method in similar past period. Conclusion: Using portfolios for evaluation of medical students' performance in community educational fields is proposed as a performance-based approach. Key Words: Portfolio, Evaluation, Medical students, Health center

Triiodothyronine Mitigates Cardiac Dysfunction in Aluminum Phosphide Poisoning: Findings from a Randomized Clinical Trial

Introduction: Aluminum phosphide (AlP) poisoning, commonly known as rice tablet poisoning, is a lethal method of suicide with no known antidotes. Thyroid hormones have inotropic effects that can potentially reverse hemodynamic instability and improve cardiac output. This study investigated the effects of Triiodothyronine (T3) on the cardiac function of patients with aluminum phosphide poisoning.Methods: In this randomized clinical trial, 24 patients with confirmed ALP poisoning were recruited. The intervention group received T3 treatment in addition to standard treatment, while the control group received only standard treatment. Demographic variables, cardiac parameters, biochemical markers, and oxidative stress tests were evaluated.Results: The majority of participants were men (60%) in their thirties (intervention: 32±17.4 years; control: 30±11.6 years). Following treatment, both systolic and diastolic blood pressures had significantly higher mean differences in the T3 group compared to the control group (18.7±9.3, P=0.05 and 14.1±5.9, P=0.03 respectively). While both groups showed improvement in mean arterial pH, the intervention group exhibited a significantly greater improvement 12 hours after the administration of T3, which was significantly different from both the baseline and control groups (p=0.04, 0.009 respectively). Additionally, the intervention group had a lower QRS and QTc interval compared to admission time.Conclusion: Triiodothyronine administration has been shown to maintain a higher range of SBP, control cardiogenic shock, regulate metabolism, improve acidosis and blood pressure, and ultimately enhance recovery in patients with aluminum phosphide poisoning. Furthermore, it may have cardio-protective effects on these patients

Effects of sexual education mobile applications on men’s sexual awareness and satisfaction: A randomized controlled trial

BACKGROUND: Sexual education programs can improve sexual awareness and satisfaction. Yet, sex education is ignored in developing countries. Under such circumstances, we have used IT tools to improve sexual education. OBJECTIVE: In this article, we used a mobile application (mHealth) to impart sex education. Methods: A randomized controlled trial was held, in which participants were randomly assigned to one of two groups: The control group, with 25 participants, which received only counseling from sex therapists, and the intervention group, with 25 participants, which received the mobile application system in addition to counseling from sex therapists. Participants were persons referred to sex therapists at a clinic. In each group, sexual satisfaction and awareness were evaluated. We measured sexual satisfaction with the help of the Larson questionnaire and sexual awareness by the Ann Hooper questionnaire. Results: Our data demonstrated that sexual satisfaction was not statistically significant (P=0.44), but awareness showed statistically significant differences (P=0.007) in the intervention vs. the control group. Also, the mean in both groups had statistically significant differences before and after the intervention (P=0.001). Conclusion: Our results showed that mobile applications can improve sexual awareness but cannot affect sexual satisfaction in the short term. Trial Registration: The clinical trial was registered with the Iranian Registry of Clinical Trials (IRCT) under registration ID:&nbsp; IRCT2016110130640N

Parental willingness to pay for child safety seats in Mashad, Iran

<p>Abstract</p> <p>Background</p> <p>Iran has one of the highest rates of road traffic crash death rates throughout the world and road traffic injuries are the leading cause of years of life lost in the country. Using child car safety seats is not mandatory by law in Iran. The purpose of this research was to determine the parental willingness to pay (WTP) for child restraints in Mashad, the second most populated city in Iran with one of the highest rates of road traffic-related deaths.</p> <p>Methods</p> <p>We surveyed 590 car-owner parents of kindergarten children who were willing to participate in the study in the year 2009. We asked them about the maximum amount of money they were willing to pay for car safety seats using contingent valuation method.</p> <p>Results</p> <p>The mean age of children was 33.5 months. The median parental WTP for CSS was about $15. Considering the real price of CSSs in Iran, only 12 percent of responders could be categorized as being willing to pay for it. Family income level was the main predictor of being willing to pay.</p> <p>Conclusions</p> <p>The median parental WTP was much lower than the actual price of the safety seats, and those who were of lower socio-economic class were less willing to pay. Interventions to increase low-income families' access to child safety seats such as providing free of charge or subsidized seats, renting or health insurance coverage should be considered.</p