The neglected sociobehavioral risk factors of low birth weight

Background: Low Birth Weight (LBW) is one of the most important health indicators in the world. It has certain known and unknown causes. The present study was designed to evaluate the role of socio-behavioral factors on neonatal birth weight.Methods: The current case-control study was conducted on 300 eligible neonates (150 LBW infants as cases and 150 normal body weight infants as controls) in 2015. The national pregnancy care forms of the neonates kept in heath care centers in Kerman were used. The data was analyzed running Independent samples t-test, Chi square test, and Fisher’s Exact test in SPSS. The significance level was set as 0.05.Results: Preterm birth (P<0.001), number of primary care during pregnancy (P=0.001), mother’s age (P=0.049), consumption of supplements during pregnancy (P=0.03), and history of substance abuse in mothers (P=0.03) were found to have significant roles in having LBW neonate.Conclusion: Identifying the sociobehavioral risk factors of Preterm labor and modifying them to prevent preterm birth are essential approaches to prevent LBW. Governments should pay special attention to nutritional status of teenage and young girls to have healthy mothers and babies in the future. Women of childbearing age should be screened and educated about risky behaviors. Pregnancy care and support should be delivered to all pregnant women according to the standard methods.

An Investigation of the Relationship between Depression, Anxiety, and Somatization Disorder in Outpatients

Background & Objectives: Nowadays, many patients refer to outpatient clinics due to anxiety, depression, and somatization disorders. These disorders have catastrophic costs for the health care system. The present study examined the relationship between depression, anxiety, and somatization in outpatients. Methods: This descriptive-analytical study was conducted in 2018 on 400 patients over 18 years old who referred to a selected clinic in Kerman and were selected using a convenience sampling method. Data were collected using the Hospital Anxiety and Depression Scale as well as Physical Health Questionnaire. Logistic regression statistical tests were used to analyze the data. Data were entered into SPSS statistical software version 20. Results: The results of this study indicated that 38.8% of outpatients had a somatization disorder, 73.5% had anxiety and 61.2% had depression. Depression was associated with an increased risk of somatization in such a way that a one-unit increase in the depression score increased the risk of somatization 1.12 times. Conclusion: Training physicians to timely diagnose and treat mental disorders, especially depression has a significant impact on reducing the burden of physical and mental illnesses. Key­words: Somatization Disorders, Depression, Anxiety, Outpatients, Clinic Citation: Danaei M, Garrusi B, Zangiabadi S. An Investigation of the Relationship between Depression, Anxiety, and Somatization Disorder in Outpatients. Journal of Health Based Research 2020; 5(4): 383-93. [In Persian

Effects of aspirin on adverse pregnancy outcome in patients with abnormal aneuploidy screening biochemistry tests: A randomized clinical trial

Subject: The aim of this research is to study the effects of low dose aspirin on preventing any adverse pregnancy outcome in women with aneuploidy abnormal screening tests in second quarter and to compare the effects of aspirin on normal and abnormal Doppler.Method: This clinical trial study was performed on pregnant women with abnormal aneuploidy screening tests and normal Karyotype at the gestational age 15-18 week. It consists of 83 persons in aspirin receiving group and 84 persons in control group. Doppler ultrasound was simultaneously done on them to survey the Doppler results. Any adverse pregnancy outcome (APO) was compared between two groups.Results: The frequency of APO was 32.8% in aspirin receiving group and 41.7% in control group (p=o.o14, RR=0.438). The frequency of preterm delivery before 37th week in the group receiving aspirin with normal Doppler was 8.07% and in the control group was 32.7% (P=0.025). The frequency of NICU reception with normal Doppler was 5.8% in aspirin group and 19.7% in control group (p=0.015). APO frequency in the group with many abnormal factors was 11.5% in the group receiving aspirin and 53.8% in control group (p=0.015). APO frequency in abnormal Doppler group was 46.7% in the group receiving aspirin and 50% in control group (p=0.849, RR=0.112).Conclusion: Low dose of aspirin reduces APO. It reduces preterm delivery and reference of pregnant women to NICU with abnormal aneuploidy screening tests

Growth monitoring in children with low and normal birth weight up to two years: A retrospective cohort study

Objective: This study was conducted aimed to compare the growth indices in 2 years old children with a history of low birth weight with normal birth weight children.Methods: Current retrospective cohort study on all two-year children with low birth weight and three times the normal weight children covered by health centers of Kahnooj, was conducted in 2015. Cares at birth, 1, 2, 4, 6, 7, 9, 12, 15, 18 and 24 months of age were studied and, child growth indices (weight, height, head circumference), along with some demographic variables were studied. Information were entered SPSS version 20 and the analysis was performed.Results: There were significant differences in children's growth of both groups in all periods of care. Despite the same slope, growth pattern in children showed a significant difference. Young mother, girl sex of baby and preterm birth are predictor factors of low birth weight.Conclusion: Trends and growth patterns of weight, height and head circumference in underweight children have significant difference with normal children and, despite the same slope, these children can not compensate for the backwardness of its growth to the age of two. So you need to plot separate growth curves for these children and, possible preventive measures should be taken to prevent bearing underweight baby

Physical activity and its determinant factors among medical students of Kerman University of Medical Sciences

  Background: Exercise can play an important role in preventing chronic diseases. Given the key role of medical students on public health behaviors, the aim of the present study was to assess physical activity and factors influencing it in medical students of Kerman University of Medical Sciences.  Methods: The present cross-sectional study was conducted on 600 medical students of Kerman University of Medical Sciences, using census method, over a six-month period. The valid and reliable self-administrate international physical activity questionnaire was used. Relevant data were fed into IBM SPSS Statistics for Windows, Version 20.0. The data were analyzed using chi-square test, ANOVA and multinomial logistic regression.    Results: The level of physical activity was low in 275 (53.1%), moderate in 187 (36%), and vigorous in 57 (10.9%) of the participants. Students whose mothers or fathers had freelance jobs were 0.38 (P=0.005) or 0.54 (P=0.033) times less likely to have moderate physical activity compared with those whose mothers or fathers were retired. Students whose fathers had ‘lower than diploma’ education were 3.15 times more likely to have moderate physical activity (P=0.003). Comparing vigorous to low physical activities, students whose fathers were in governmental jobs were 3.15 times more likely to have vigorous physical activity (P=0.036). Also, students whose fathers had ‘lower than diploma’ education level were 0.17 times less likely to have vigorous physical activity (P=0.004).  Conclusion: Medical students in Iran are not in a good status in terms of physical activity. Considering the decisive role of parents in their children's attitudes towards physical activity, even in college, parent training seems necessary

Compliance with standard precautions, sharp injuries, and blood and body fluid exposure among healthcare workers

Background & Aim: Healthcare workers are exposed to certain infectious diseases through needlestick injuries and exposure to blood and other bodily fluids. This study aimed to determine the prevalence of needlestick injuries and blood and other body fluids exposure among healthcare workers at Namazi Hospital in Shiraz, Iran. Methods & Materials: This cross-sectional study was conducted on 656 Healthcare workers, including students and staff in medical, nursing, laboratory, service, and operating room groups, at the Namazi Hospital, in 2019. A questionnaire with four parts, including demographics, questions about using sharps containers, needle recapping, masks, and glasses, and the experience of sharps injuries or blood and body fluid exposure and reporting them, was distributed using the quota sampling method. To analyze the results, the T‑test and Chi-square test were performed. Results: Nearly 75.2% of the participants always used sharps containers, and 21.7% never recapped syringes. Sharps injuries and blood and body fluid exposure occurred in 40.7% and 39.8% of the participants. Occupation (P 0.05). Conclusion: Hospital managers should provide effective educational interventions to protect against occupational hazard exposures. Also, they should provide protective equipment for Healthcare workers

Prevalence of Dysglycemia Among Coronary Artery Bypass Surgery Patients with No Previous Diabetic History

<p>Abstract</p> <p>Background</p> <p>Dysglycemia is a major risk factor for atherosclerosis. In many patient populations dysglycemia is under-diagnosed. Patients with severe coronary artery disease commonly have dysglycemia and there is growing evidence that dysglycemia, irrespective of underlying history of diabetes, is associated with adverse outcome in coronary artery bypass graft (CABG) surgery patients, including longer hospital stay, wound infections, and higher mortality. As HbA1c is an easy and reliable way of checking for dysglycemia we routinely screen all patients undergoing CABG for elevations in HbA1c. Our hypothesis was that a substantial number of patients with dysglycemia that could be identified at the time of cardiothoracic surgery despite having no apparent history of diabetes.</p> <p>Methods</p> <p>1045 consecutive patients undergoing CABG between 2007 and 2009 had HbA1c measured pre-operatively. The 2010 American Diabetes Association (ADA) diagnostic guidelines were used to categorize patients with no known history of diabetes as having diabetes (HbA1c ≥ 6.5%) or increased risk for diabetes (HbA1c 5.7-6.4%).</p> <p>Results</p> <p>Of the 1045 patients with pre-operative HbA1c measurements, 40% (n = 415) had a known history of diabetes and 60% (n = 630) had no known history of diabetes. For the 630 patients with no known diabetic history: 207 (32.9%) had a normal HbA1c (< 5.7%); 356 (56.5%) had an HbA1c falling in the increased risk for diabetes range (5.7-6.4%); and 67 (10.6%) had an HbA1c in the diabetes range (6.5% or higher). In this study the only conventional risk factor that was predictive of high HbA1c was BMI. We also found a high HbA1c irrespective of history of DM was associated with severe coronary artery disease as indicated by the number of vessels revascularized.</p> <p>Conclusion</p> <p>Among individuals undergoing CABG with no known history of diabetes, there is a substantial amount of undiagnosed dysglycemia. Even though labeling these patients as "diabetic" or "increased risk for diabetes" remains controversial in terms of perioperative management, pre-operative screening could lead to appropriate post-operative follow up to mitigate short-term adverse outcome and provide high priority medical referrals of this at risk population.</p

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI &lt;18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school&#x2;aged children and adolescents, we report thinness (BMI &lt;2 SD below the median of the WHO growth reference) and obesity (BMI &gt;2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Knowledge, attitudes, and practices regarding pandemic h1n1 influenza among medical and dental residents and fellowships in Shiraz, Iran

Background: Influenza disease is one of the oldest medical problems that can cause severe illness and high mortality rates, worldwide. In flu pandemics, medical and dental students′ knowledge, attitudes, and practices (KAP) is critical to save patients life. The aim of this study was to determine the score of KAP toward the Pandemic H1N1 and their predictor factors among the medical and dental residents and fellowships of Shiraz University of Medical Sciences, Iran. Methods: In 2009, 125 participants were recruited in a convenient sampling cross-sectional survey. Self-reported questionnaire were used and results were analyzed applying appropriate statistical tests. Results: The mean score of participants′ knowledge, attitude and practice were 22.6, 21.1 and 26.5 respectively. Participants practice had significant linear positive correlation with knowledge and attitude. Also, their age was significantly and directly correlated to knowledge and practice. The educational major, age, and sex were significant predictors of responder′s knowledge score and age was the only significant predictor of both attitude and practice scores. Conclusions: High knowledge is not sufficient lonely for improve attitude and practices.It seems that traditional educational models are not efficient and governments should emphasize to advanced and motivational education methods including health belief model and motivational interview at postgraduate levels. Perhaps younger students, dentists and males have less motivation to change their attitude and behavior, so we can focuses our interventions in these groups

Anxiety and Pain Severity in Children Based on Self-Report

Background and Objective: Evaluation of the severity of pain in children can help the medical team diagnose the type of disease. In this study, anxiety and pain intensity in children were examined based on self-report. Materials and Methods: This cross-sectional study was performed in 2018 on 300 children aged 3 to 12 years, referring to outpatient treatment centres in Kerman. To measure the severity of pain felt by children, FPS-R was used. The level declared by children was evaluated by the pain intensity estimated by parents and doctors using a visual analogue scale (VAS) and the standard FLACC (Face, Legs, Activity, Cry, Consolability scale) for correlation. The data were analysed using SPSS software version 25. Results: The pain reported by children was obtained by VAS (4.16 ± 3.49), and the estimated pain by the doctor was obtained by FPS-R (2.87±1.68). The pain severity estimated by the doctor using FLACC had the highest correlation with the pain estimated by the doctor using VAS and the lowest correlation with the pain estimated by the mother using VAS. Conclusion: The results of this study showed that FPS-R could be used as a suitable self-report tool in children and, along with the standard FLACC, can help the medical team recognize the severity of children's pain