Epidemiology of Acute Poisoning in Mazandaran Province, Iran

Background: Poisoning is a critical medical emergency worldwide. The present study aimed to determine the characteristics and treatment outcomes of patients admitted to the poisoning department.Methods: This cross-sectional descriptive study was conducted from March 2015 to September 2016 (for 18 months). We explored the epidemiology of poisoned patients hospitalized at Razi and Imam hospitals in Mazandaran Province, Iran. The obtained results were described as the frequency of poisoning, percentages, confidence intervals (95% CI), and mean values. The standard deviation scores were also presented for quantitative variables. The Student t-test and Chi-squared test were used for data analysis.Results: The prevalence rate of poisoning equaled 4.98% of the total hospitalized patients. Of 71192 of the investigated cases, 3544 patients were hospitalized for acute poisoning. In terms of poisoning type, 65.2% belonged to drug toxicity, (95% CI) (64.7-77.2); 6.7% were related to methadone; 5.7% to an agricultural pesticide; 4.15% to aluminum phosphide (rice tablets); 2.2% to rat poison paste, and the remaining cases were caused by other poisons. There was a gender-wise significant difference in the poisoning method (P<0.001). The mortality rate in this study was calculated as 1.71% of all cases. The most frequent causes of death were aluminum phosphide (33.33%) and narcotics (16.16%) poisonings. Conclusion: Acute poisoning is a fundamental health problem in Mazandaran Province, i.e., located in the north of Iran. Pharmaceutical medications, opioid agents, and aluminum phosphide were the main means of poisoning in the investigated adult patients. Most cases of poisoning occurred in the young-adult groups. Aluminum phosphide and organophosphate agents consumption generated the most critical states and were the main causes of death. It is suggested that aluminum phosphate be recalled from the market, as appropriate training must be provided for its proper use

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

The structural factors of social determinants of health on Iranian women's childbearing: a systematic review study

Introduction: Childbearing is an important phenomenon in demographic movements and the basis of sustainable development in countries with low replacement fertility rates. The present study was performed with aim to summarize the existing knowledge about the effectiveness of structural factors of social determinants of health on childbearing of Iranian women. Methods: In this systematic review, observational Persian and English studies published from 1/1/2010 to 23/1/2022 were included in the study. Studies were searched in Magiran, SID, Embase, google scholar, Scopus, web of science, and PubMed databases using related keywords including: Reproductive Behavior, Childbearing, Socioeconomic Factors, Ethnic Groups, Culture, Structural Determinants of Health and Iran. The Newcastle-Ottawa tool was used to evaluate the quality of the articles. Results: In this review study, 36 studies which met the inclusion criteria were included in the study, and health structural factors (education, income, occupation, ethnicity, and culture) on women's childbearing were examined. Women's childbearing is related to these structural factors of health. In this review study, the highest frequency was related to women's education; so that 18 articles showed the negative effect of education on childbearing. Conclusion: The results of the present systematic review showed the effect of structural social determinants of health (education, income, occupation, ethnicity, and culture) including women's education on childbearing. This confirms that if population policies can implement programs that make the mother's role compatible with the continuation of women's education after marriage, they can be much more effective

Associations of psychosocial factors with pregnancy healthy life styles.

Healthy behaviors in pregnant women have a major effect on pregnancy outcomes; however, only few studies have explored the relationship of multiple psychosocial factors with healthy lifestyles during pregnancy. The objective of this study was to investigate whether the five psychosocial factors of anxiety, stress, depression, marital dissatisfaction, and social support are associated with six domains of healthy lifestyles in pregnant women, including nutrition, physical activity, health responsibility, stress management, interpersonal relationships, and self-actualization. In this cross-sectional study, 445 pregnant women from the obstetrics clinics of the teaching hospitals of Babol University of Medical Sciences were included. The subjects answered six questionnaires, including the Health-Promoting Lifestyle Profile, Beck Depression Inventory, Prenatal Distress Questionnaire, State-Trait Anxiety Inventory, Social Support Questionnaire, and Marital Satisfaction Scale. We developed a series of simple linear regression models based on each subscale of lifestyle (nutrition, physical activity, health responsibility, stress management, interpersonal relationships, and self-actualization) as the dependent variables and the five psychological variables (anxiety, stress, depression, marital dissatisfaction, and social support) as the independent variables. State and trait anxieties were the strongest negative predictors of all aspects of a healthy lifestyle. Furthermore, depression was negatively associated with all of the six subscales of a healthy lifestyle. Pregnancy-specific stress was the only negative predictor of stress management and self-actualization. Marital dissatisfaction was negatively associated with nutrition, stress management, health responsibility, and self-actualization. Social support had negative and positive associations with healthy behaviors. The study suggests that more attention should be paid to identifying the psychological risk factors in pregnancy in addition to providing suitable interventions for improving the lifestyle of pregnant women

Late-pregnancy sleep quality and psychological distress in Iranian primiparous women

Background: Even though pregnant women commonly experience poor sleep quality during pregnancy, the role of sleep quality in psychological problems is still unclear. This study was carried out to determine the associations between poor sleep quality in the third trimester of pregnancy and the psychological distress among Iranian primiparous women. Methods: This cross-sectional study was carried out on 300 primiparous women who attended prenatal care centers in Babol, Iran, in 2019. The sleep quality and the psychological status of the pregnant women were measured with Pittsburg sleep quality index (PSQI) and Symptom CheckList-90 (SCL-90), respectively. Bivariate and multivariable logistic regression analyses were used to examine the association(s) between independent, dependent, and control confounding variables. Results: Poor sleep quality was found in 74% of the participants. Poor sleep quality was not associated with psychological distress (the total score of SCL-90-R). Compared with women with good sleep quality, women with poor sleep quality were more likely to have hostility (adjusted OR = 2.51; CI = 1.13, 5.55), somatization (adjusted OR = 4.31; CI = 1.96, 9.47), and less paranoid (OR = 0.22; CI = 0.11, 0.44) during the third trimester of pregnancy. Conclusion: It is suggested that poor sleep quality was significantly associated with subscales of SCL-90 (hostility and somatization, paranoid) during the third trimester. Thus, further research on the topic is needed

The Maternal Postpartum Quality of Life Instrument (MPQOL-I): development and psychometric evaluation in an exploratory sequential mixed-method study

Abstract Background “ Postpartum quality of life” refers to women’s satisfaction of their position in life, based on cultural status, expectations, values, attitudes, goals, and living standards. Hence the need to pay attention to more specific dimensions of quality of life in the postpartum period is being sensed. This study was conducted to develop the Maternal Postpartum Quality of Life Instrument (MPQOL-I) and assess its psychometric properties. Methods This methodological study was conducted in 2019–2020. This exploratory, sequential mixed-method study was conducted in two phases. The first phase is MPQOL-I development and the second phase is psychometric evaluation of the developed scale. In the quantitative (psychometric evaluation) phase, face, content, construct, convergent, and discriminant validity and reliability of the scale were tested. Results In this study, 5 factors were extracted from items through exploratory factor analysis: (1) received support, (2) sexual relations, (3) bonding with newborn, (4) breastfeeding and newborn care, and (5) the transition period. These factors accounted for 53.26% of the total variance. The results of the confirmatory factor analysis suggested the goodness-of-fit indices was acceptable. Furthermore, the internal consistency and composite reliability indices of factors were greater than 0.7. Conclusion The sixteen-item Persian language MPQOL-I is a valid and reliable instrument for postpartum quality of life assessment. It includes items from different aspects of postpartum quality of life and can be used for the early diagnosis of impaired postpartum quality of life. Further studies are needed to assess the psychometric properties of MPQOL-I in different cultures and communities

Correlation coefficient between healthy life styles and psychosocial variables.

<p>Correlation coefficient between healthy life styles and psychosocial variables.</p

Effectiveness of computer-based stress inoculation training (SIT) counseling approach on anxiety, depression, and stress of students with premenstrual syndrome

Abstract Background Premenstrual Syndrome (PMS) is a common public health issue affecting many women of reproductive age worldwide. This study has been designed to investigate of computer-based stress inoculation training (SIT) counseling approach on anxiety, depression, and stress of university students with PMS. Methods A randomized trial study with two parallel arms was done from 30 October 2022 to 21 June 2023 on 100 university students aged 18 to 38 at Babol University of Medical Sciences. The participants were randomly divided into two groups intervention and control. The data collection tools included questionnaires on demographic-fertility characteristics, the Premenstrual Symptoms Screening Tool (PSST), the Hospital Anxiety and Depression Scale (HADS), the Perceived Stress Scale (PSS-14), the Sheehan Disability Scale (SDS) and Riff’s Psychological Well-being Scale (RPWS). The data were assessed using chi-square, t-student, ANOVA repeated measure, and linear regression tests. A significance level of P < 0.05 was considered for the analysis. Results The results of the study showed that the SIT interventions decreased the PMS severity and most psychological factors so in the intervention group, SIT was able to significantly reduce anxiety, depression, perceived stress, and Sheehan’s disability after intervention (P < 0.001). Based on multiple linear regression analysis, the most predictors of HADS were the PSS and SDS (β = 0.285, p = 0.009 and β = 0.236, p = 0.024, respectively). Conclusion The computer-based SIT counseling approach could reduce the severity of symptoms and psychological factors in students. Therefore, SIT intervention is recommended to manage their PMS. Trial registration IRCT20230130057274N2

The mean scores of the life style and psychosocial factors of pregnant women in early, mid, and late pregnancy.

<p>The mean scores of the life style and psychosocial factors of pregnant women in early, mid, and late pregnancy.</p

The prevalence of adjustment disorder and predisposing factors in infertile women

Abstract Background Infertility is a stressful life event that increases the risk of developing mental disorders, particularly adjustment disorder (AD). Given the paucity of data on the prevalence of AD symptoms in infertility, the purpose of this study was to ascertain the prevalence, clinical presentation, and risk factors for AD symptoms in infertile women. Method In a cross-sectional study, 386 infertile women completed questionnaires including the Adjustment Disorder New Module-20 (ADNM), the Fertility Problem Inventory (FPI), the Coronavirus Anxiety Scale (CAS), and the Primary Care Posttraumatic Stress Disorder (PC-PTSD-5) at an infertility center between September 2020 and January 2022. Result The results indicated that 60.1% of infertile women exhibited AD symptoms (based on ADNM > 47.5). In terms of clinical presentation, impulsive behavior was more common. No significant relationship was observed between prevalence and women's age or duration of infertility. Infertility stress (β = 0.27, p < 0.001), coronavirus anxiety (β = 0.59, p = 0.13), and a history of unsuccessful assisted reproductive therapies (β = 2.72, p = 0.008) were several predisposing factors for AD symptoms in infertile women. Conclusions The findings suggest that all infertile women be screened from the start of infertility treatment. Additionally, the study suggests that infertility specialists should focus on combining medical and psychological treatments for individuals predisposed to AD, particularly infertile women who exhibit impulsive behaviors