Investigation of diabetes prevention behaviors among teachers of different level of education based on Pender model in selected educational centers in southwestern Iran, 2019

Introduction: Diabetes is a metabolic disorder groupreferred as a “silent epidemic”. Teachers’ justification attraining courses and explaining health promoting behaviorsto students can develop these behaviors to the communityand improve the health status of the general publicin the long term. Therefore, by examining the healthpromotingbehaviors in this community playing the mostimportant role in promoting knowledge, we can take stepsto enhance the level of public health in diabetic people.Methodology: This research is a retrospective cross-sectionalstudy in which 200 teachers of different levels ofeducation in southwestern of Iran participated. The PenderHealth Promotion Model Questionnaire was used to collectinformation.Results: 108 (54%) of participants were male and 92 (46%)of them were female. Their mean age was 39.95±7.25.The highest score of the questionnaire among these behaviorsbelonged to spiritual growth (24.81) and the lowestscore (13.13) belonged to interpersonal relationship.Conclusion: Based on the results of this study, the necessityof interventions, especially with an emphasis on physicalactivity and interpersonal relationships among teachersis necessary. Appropriate planning and application of themin eliminating the barriers, development and expansion offacilities, encouragement of people through health educationcan be the appropriate interventions in this regard

Effect of CO2 laser irradiation on the surface of the polycrystalline ceramic bracket and the rate of canine movement with sliding mechanic

Introduction: Metal brackets are the most commonly used brackets in clinical orthodontics, but the sight of color of the metal bracket can be unpleasant for some patients. Ceramic brackets offer the desired beauty but they have higher frictional resistance. Considering that in vitro studies suggest that CO2 laser reduces the friction between the wire and slot of the bracket in the sliding mechanics, the aim of this study was to evaluate the clinical effect of CO2 laser on the speed of tooth movement using the sliding mechanics. Materials & Methods: This randomized double-blind clinical trial was performed on 7 patients and a total of 13 half jaws in each group. These patients were candidates for bilateral extraction of the first premolars due to lack of space or dentoalveolar protrusion. After alignment and leveling, the ceramic brackets were passively bonded. The ceramic brackets of the experimental group irradiated with the CO2 laser and the brackets of the control group were bonded unchanged. The brackets were examined with an atomic force microscope (AFM) before and after irradiation. Statistical data were analyzed paired t-test to compare the rate of gap closure between the two groups at one-month intervals. ANOVA was used to examine the reduction in spacing at three-month intervals. A value of p<0.05 was considered statistically significant. Results: The rate of gap closure between the two groups was compared at one-month intervals, which was not statistically significant in either month. Furthermore, in the comparison between the study and control groups, the decrease in the distance between the canine and second premolars was not statistically significant after a total of three months (p=0.0918). Conclusion: According to the results of this study, CO2 laser irradiation of the bracket surface has no effect on the speed of movement of the canine when sliding on the wire

A comparative study on effectiveness of workshop education versus education via mobile learning (m-learning) in developing medical students’ knowledge and skill about cardiopulmonary resuscitation

INTRODUCTION: A variety of educational approaches are being used today to improve learning in the field of cardiopulmonary resuscitation. Therefore, the present study was conducted to compare workshop education with education via mobile learning (M-learning) in terms of their efficacy in developing medical students’ knowledge and skills about cardiopulmonary resuscitation. MATERIAL AND METHODS: The present study was quasi-experimental performed on 60 interns selected from a university of medical sciences in southwest Iran. Participants were assigned to either the workshop education group (n = 30) or the mobile learning group (n = 30). Before and after the intervention, the knowledge and skills of the participants in terms of basic and advanced cardiopulmonary resuscitation were measured by a questionnaire. The collected data were analyzed using descriptive statistics, Independent-Samples t-Test, Paired-Samples t-Test, and Chi-Square Test in SPSS software v. 22. RESULTS: Education via mobile learning caused a significant increase in the participants’ knowledge about cardiopulmonary resuscitation (p &lt; 0.05). However, this method did not result in a significant difference in the participants’ skill scores, while the workshop education group showed a significant increase in their cardiopulmonary resuscitation skill scores (p &lt; 0.05). CONCLUSIONS: Our results revealed that education via mobile learning was better in enhancing medical students’ knowledge about cardiopulmonary resuscitation. However, workshop education was more effective in developing practical skills in the field of cardiopulmonary resuscitation. Accordingly, educators are recommended to employ a combination of mobile learning and workshop education for achieving better results

Risk factors related to COVID-19 survival and mortality: a cross-sectional-descriptive study in regional COVID-19 registry in Fasa, Iran

INTRODUCTION: The COVID-19 pandemic, as the most important health challenge in the world today, has made numerous irretrievable damages to the social, economic, and health dimensions of societies, especially in developing countries. An essential measure that can be taken to prevent and control the disease is to identify risk factors related to its prognosis and mortality rate. Therefore, this study aimed at investigating COVID-19 survival and mortality risk factors and their relationship with the demographic characteristics of the subjects diagnosed with the disease. MATERIAL AND METHODS: The present study is cross-sectional and descriptive. The samples consist of 1395 patients diagnosed with COVID-19 admitted to medical centers affiliated with Fasa University of Medical Sciences. The subjects were selected by census sampling. Data were collected using demographic information forms, paraclinical and radiological tests, and clinical examinations. Data were analyzed using SPSS version 18 via descriptive tests, paired t-tests, one-way ANOVA, and post hoc tests. RESULTS: According to the data, the participants’ average age was 57.72 ± 4.63 years, and most of them (56.41%) were male. The mortality rate among the participants was estimated to be 13.19%. The results of the study showed a significant relationship between the survival status of patients with COVID-19 and underlying chronic diseases such as diabetes and cardiovascular and renal diseases (p &lt; 0.05). CONCLUSIONS: Identifying high-risk groups is an important measure that health professionals should consider in controlling epidemics. The findings of this study showed that the presence of underlying chronic diseases such as diabetes and cardiac and renal conditions, which are associated with immune system defects, are among the most important factors related to the COVID-19 mortality

Spontaneous relapse in patients with inactive chronic hepatitis B virus infection

Background: Chronic hepatitis B virus infection (HBV) may reactivate during the course of the disease and is called spontaneous relapse. The purpose of this study was to evaluate the incidence of relapse of hepatitis in subjects with inactive HBV carriers. Methods: This follow-up study was performed on 785 patients with inactive HBV carriers that were followed-up at six month intervals. The presence of serum HBsAg and anti-HBe, without HBeAg, HBV DNA levels <2000 IU/ml with normal alanine aminotransferase (ALT) levels was defined as inactive carriers. Patients who developed ALT ≥80 IU/L with HBV DNA levels ≥2000 IU/ml were considered as spontaneous relapse. Results: Seven hundred- eighty five cases (441 males, 344 females) of chronic HBV infected individuals were followed-up. The mean age at the entrance of the study was 30.5±11.8 years. The mean follow-up duration was 5.9±5 years. Relapse was seen in 35 (4.5%) cases, in 27 out of 441 (6.1%) males and in 8 out of 344 (2.3%) females and in 4.2% subjects ≥30 years versus in 4.7% cases of under 30 years (p>0.05). The development of relapse in males was higher than females (hazard ratio 2.53, 95% CI 1.2-5.6, p=0.021), but age ≥30 or <30 years did not have effect (hazard ratio1.21, 95% CI 0.62-2.36, p=0.58). Conclusions: The results show that spontaneous relapse of hepatitis may develop during the course of chronic HBV infection. We suggest that all patients with chronic hepatitis B, regardless of their age, be examined for the possibility of relapse

The Effect of Peer Group-Based Training Using Health Belief Model on Quality of Life and Foot Ulcer Self-Care Behaviour in Patients with Type 2 Diabetes: A Randomized Controlled Clinical Trial

Objective: The present study was aimed at investigating the effect of peer group-based training (PGBT) using the health belief model (HBM) on the quality of life (QOL) and foot ulcer self-care behavior  in patients with type 2 diabetes. Materials and methods: The present study was a randomized controlled clinical trial performed on patients with type 2 diabetes who were referred to the Diabetic Care Clinic in Shiraz (Iran) from September 2019 to June 2020. A total of 70 patients participated in the study and were randomly assigned to peer training (n = 35) and control groups (n = 35). Diabetes Quality of Life, and diabetes self‑care behaviors, which were completed by both groups before, immediately, 1 month, and 3 months after the intervention. The data were analyzed using the Chi‑square test, paired t-test, independent t‑test, ANOVA, and descriptive statistical methods. P &lt; 0.05 was considered statistically significant. Results: The results showed that mean scores of QOL, constructs of HBM (awareness, perceived susceptibility, perceives severity, perceived benefit, self-care behavior, and foot care) before the intervention did not reveal a significant difference between the two groups, but immediately one month after the educational intervention, the mean values for the intervention group were significantly higher than the control group (p &lt; 0.05). Conclusions: PGBT using HBM was effective in increasing the mean score of QOL and self-care behavior in patients with type 2 diabetes. Thus, this method is recommended to be utilized alongside other methods to train patients

Correlation of resting heart rate with anthropometric factors and serum biomarkers in a population-based study: Fasa PERSIAN cohort study

BACKGROUND: There is a positive association between raised resting heart rate (RHR), and all causes of mortality and shorter life expectancy. Several serum biomarkers and some anthropometric factors can affect the resting heart rate. This study aimed to investigate the determinants of resting heart rate in a large random sample of the Iranian population. MATERIAL AND METHODS: It is a standardized, retrospective study and the subjects were chosen from the baseline survey of the Prospective Epidemiological Research Study in IrAN (PERSIAN) Fasa non-communicable disease cohort study. It was conducted from winter 2014 to summer 2019 and after obtaining informed consent from a random sample, all the eligible subjects were enrolled. All anthropometric factors and biologic laboratory factors were collected and analyzed by implement smoothly clipped absolute deviation (SCAD) linear regression and SCAD quantile regression. The comparisons between males and females were done via independent T-test. RESULTS & CONCLUSION: A total number of 9975 persons from 35 to 90 years old were included. The overall median resting heart rate was 74 (interquartile range:66-80). Mean age has no important difference between males and females (P = 0.79) but, resting heart rate was significantly higher in females (76.6 versus 71.4, P < 0.001). All anthropometric factors except wrist circumference were higher in females (P < 0.05). Age has an adverse effect on resting heart rate and also, there was a direct association between resting heart rate and systolic blood pressure and blood glucose. Alpha-blockers (coefficient = 5.2) and Beta1-blockers (coefficient = - 2.2) were the most effective drugs with positive and negative effects on resting heart rate respectively. Lower hemoglobin, obesity, and more body mass index, and more low-density lipoprotein were associated with more resting heart rate. Continuing the monitoring of this sample via our cohort study and put to action multinational prospective researches with large sample sizes and long follow-ups can lead to more precise results and better scientific judgments

Angiotensin-converting enzyme genotype and late respiratory complications of mustard gas exposure

<p>Abstract</p> <p>Background</p> <p>Exposure to mustard gas frequently results in long-term respiratory complications. However the factors which drive the development and progression of these complications remain unclear. The Renin Angiotensin System (RAS) has been implicated in lung inflammatory and fibrotic responses. Genetic variation within the gene coding for the Angiotensin Converting Enzyme (ACE), specifically the Insertion/Deletion polymorphism (I/D), is associated with variable levels of ACE and with the severity of several acute and chronic respiratory diseases. We hypothesized that the ACE genotype might influence the severity of late respiratory complications of mustard gas exposure.</p> <p>Methods</p> <p>208 Kurdish patients who had suffered high exposure to mustard gas, as defined by cutaneous lesions at initial assessment, in Sardasht, Iran on June 29 1987, underwent clinical examination, spirometric evaluation and ACE Insertion/Deletion genotyping in September 2005.</p> <p>Results</p> <p>ACE genotype was determined in 207 subjects. As a continuous variable, FEV₁% predicted tended to be higher in association with the D allele 68.03 ± 20.5%, 69.4 ± 21.4% and 74.8 ± 20.1% for II, ID and DD genotypes respectively. Median FEV₁% predicted was 73 and this was taken as a cut off between groups defined as having better or worse lung function. The ACE DD genotype was overrepresented in the better spirometry group (Chi²4.9 p = 0.03). Increasing age at the time of exposure was associated with reduced FEV₁%predicted (p = 0.001), whereas gender was not (p = 0.43).</p> <p>Conclusion</p> <p>The ACE D allele is associated with higher FEV₁% predicted when assessed 18 years after high exposure to mustard gas.</p

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

Global, regional, and national burden of other musculoskeletal disorders, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021

Background Musculoskeletal disorders include more than 150 different conditions affecting joints, muscles, bones, ligaments, tendons, and the spine. To capture all health loss from death and disability due to musculoskeletal disorders, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) includes a residual musculoskeletal category for conditions other than osteoarthritis, rheumatoid arthritis, gout, low back pain, and neck pain. This category is called other musculoskeletal disorders and includes, for example, systemic lupus erythematosus and spondylopathies. We provide updated estimates of the prevalence, mortality, and disability attributable to other musculoskeletal disorders and forecasted prevalence to 2050. Methods Prevalence of other musculoskeletal disorders was estimated in 204 countries and territories from 1990 to 2020 using data from 68 sources across 23 countries from which subtraction of cases of rheumatoid arthritis, osteoarthritis, low back pain, neck pain, and gout from the total number of cases of musculoskeletal disorders was possible. Data were analysed with Bayesian meta-regression models to estimate prevalence by year, age, sex, and location. Years lived with disability (YLDs) were estimated from prevalence and disability weights. Mortality attributed to other musculoskeletal disorders was estimated using vital registration data. Prevalence was forecast to 2050 by regressing prevalence estimates from 1990 to 2020 with Socio-demographic Index as a predictor, then multiplying by population forecasts. Findings Globally, 494 million (95% uncertainty interval 431–564) people had other musculoskeletal disorders in 2020, an increase of 123·4% (116·9–129·3) in total cases from 221 million (192–253) in 1990. Cases of other musculoskeletal disorders are projected to increase by 115% (107–124) from 2020 to 2050, to an estimated 1060 million (95% UI 964–1170) prevalent cases in 2050; most regions were projected to have at least a 50% increase in cases between 2020 and 2050. The global age-standardised prevalence of other musculoskeletal disorders was 47·4% (44·9–49·4) higher in females than in males and increased with age to a peak at 65–69 years in male and female sexes. In 2020, other musculoskeletal disorders was the sixth ranked cause of YLDs globally (42·7 million [29·4–60·0]) and was associated with 83 100 deaths (73 600–91 600). Interpretation Other musculoskeletal disorders were responsible for a large number of global YLDs in 2020. Until individual conditions and risk factors are more explicitly quantified, policy responses to this burden remain a challenge. Temporal trends and geographical differences in estimates of non-fatal disease burden should not be overinterpreted as they are based on sparse, low-quality data.publishedVersio