The Economic Burden of depression in psychiatric disorders

Background: Psychiatric disorders are very common, but their economic costs are not calculated transparently, while they are associated with significant economic consequences. The aim of this study was to investigate the direct and indirect costs of psychiatric disorders in 2017. Method: The present cross-sectional study was performed on all psychiatric patients admitted to hospitals in Ibn-e-Sina and Hejazi hospitals of Mashhad. According to the International book of ICD10, the medical records of psychiatric patients admitted with Code of Mental and Behavioral Disorders (F32-F33.9) were first identified and their costs of hospitalized was extracted and investigated from the Hospital Information system. The Top-Down Approach was used to estimate the costs. Descriptive statistics were used to analyze the data. Result: During the study period, 6896 patients were discharged, of which 1915 (28%) had mood disorders and among the mood patients, 300 (16%) had depression. The highest treatment cost for psychiatric patients is paid by insurance (93%). The average length of stay in the hospital was 23.6 days, and the average cost of each patient was $ 1020. The greatest cost of depression patients is related to hoteling (62%) and doctor's visit (24%). Conclusion: Depression is a common and costly disease and should be prevented by designing effective intervention

Comparison of the Effect of Pressure on Bladder-GV20 and Gallbladder-GV20 on Labor Pain Intensity among the Primiparous Women: A Randomized Clinical Trial

Background: The cycle of pain, fear, and anxiety may lead to prolonged labor and cesarean section. Acupressure is one of the methods for pain relief. Aim: Therefore,this study aimed to compare the effect of acupressure on bladder-GV20 and gallbladder-GV20 points on the labor pain in primiparous women. Method: This randomized clinical trial was conducted on 158 primiparous women, who referred to the Um Al-Benin Specialized Women Hospital, Mashhad, Iran in 2017. The first stage of labor included five and four pressure cycles on acupressure points in bladder and gallbladder in the intervention groups 1 and 2, respectively. In the second stage of labor one pressure cycle on the same points were completed. The control group only received the routine cares. The duration of uterine contractions was assessed by touching the uterus apex. Moreover, the pain intensity was evaluated by the visual analog scale. All the data were analyzed by the SPSS version 25 Results: The mean pain intensity in both stages of the intervention groups was significantly different from the control group and was significantly lower in the gallbladder group (

The effect of cognitive-behavioral group therapy on depression and quality of life in patients with chronic renal failure

Background and purpose: The aim of this study was to determine the effect of cognitive-behavioral group therapy on depression and quality of life in patients with chronic renal failure. Materials and methods: The present study was a quasi-experimental study with pretest, posttest design in experimental and control groups. The statistical population included all patients with chronic renal failure who were present for treatment in Mehr Madar Hospital in Torbat-e-Jam (A city in Iran) in the 2020 and among them 30 patients with Cochran statistical formula were selected as the research sample. And 15 people in the control group were randomly assigned. The research process was performed for both groups once a week during 8 sessions of 90 minutes (Experiment: Psychoeducation / control: to evaluate the effect of placebo, round-the-clock sessions to share their experiences with each other without the active role of psychologist and facilitator). Measurement tools included Beck Depression Inventory (II) and Quality of Life Questionnaire (SF-36). Statistical analysis of data was performed using SPSS-23 software. Results: The results showed that there was a significant difference between the experimental and control groups in both variables of depression and quality of life

Student Perceptions of Educational Environment in a New Nursing College by Dreem Tool in Iran

Introduction:  Educational environment has a critical effect on the students' learning, performance and innovations.  The aim of this study was to evaluate the perception to problem identification among nursing students in a newly-founded Nursing school in Torbat, Iran.  Materials & Methods: This cross-sectional study was conducted in a newly-founded Nursing School in Torbat. 120 students completed the questionnaire. The Dundee Ready Education Environment Measure (DREEM) was used to evaluate the educational environment. Results: Mean age of the study population was 20.81±1.55 yrs with a female/male ratio of 1.22. The mean total score of the DREEM scale was 115.67±12.4 out of 200. The mean score of all subscales of the DREEM questionnaire were "positive perception" except for the students' self-perception domain that had many negative aspects.  Conclusion: In this study the students' self-perception was not favorable according to the DREEM scale and was identified as "need to be changed and improved" in our newly-founded nursing school. Having a schedule to train nursing students and providing friendly, supportive and comfortable atmosphere can improve the educational environment

The perception and experience of infertile women who received acupressure in relation to anxiety: A qualitative study

Background: Women, who are in a critical situation like infertility, are more prone to depression, anxiety, and low self-esteem than other people. The aim of this study was to explore the deep experience of anxiety in infertile women who received acupressure during in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Materials and Methods: This qualitative, conventional content analysis study was performed on 14 infertile female participants in the Milad IVF Center in Mashhad, Iran, from September 2015 to August 2016. The study subjects included Iranian women, aged 20–45 (mean [standard deviation, SD] 29.07 [4.06]) years with primary infertility. Acupressure was performed on the Heart 7 and Pericardium 6 acupoints in 12 sessions. Data were gathered through semi-structured interviews, and transcribed, coded, and organized in different categories based on three primary phases of preparation, organization, and reporting. Results: The results showed the two major categories of “body perceptions of anxiety diminution” and “mind experiences.” The body perceptions category consisted of three subcategories, namely, reduction of nervous, cardiovascular, and gastrointestinal signs and symptoms. The subcategories of the mind experiences category consisted of emotional and cognitive consequences. Conclusions: The qualitative findings showed a number of positive outcomes in the physical and mental signs and symptoms of anxiety in infertile women undergoing IVF/ICSI, so acupressure can be used for reducing the unpleasant feelings and body perceptions of these women

Evaluation of acupressure effects on self-efficacy and pregnancy rate in infertile women under in vitro fertilization/intracytoplasmic sperm injection treatment: A randomized controlled trial

Context: Infertility is one of the major stressful events in individual life, especially women. Self-efficacy means a person can perceive a potentially threatening and stressful situation as being amenable to influences of personal control. Aims: This study was conducted to determine the acupressure effects on self-efficacy and pregnancy rate in infertile women under in vitro fertilization (IVF)/intracytoplasmic sperm injection treatment. Settings and Design: This study was a randomized controlled trial in infertile women. It performed at Milad IVF Center, Mashhad, Iran, from September 2015 to August 2016. Materials and Methods: The sample size was 144 participants. The participants were randomly divided into three groups: real and sham acupressure and control groups. Acupressure performed on the H7 and P6 acupoints on both the hands. The infertility self-efficacy scale was completed before and after intervention. Beta-human chorionic gonadotropin hormone assay was measured to determine pregnancy. Data analysis was done by Chi-square, Fisher's exact, paired sample t, Kruskal–Wallis, and ANOVA test and general linear model and multinomial logistic. Levels of significance were reported at P < 0.05. Results: The mean age of women was 30.84 ± 5.34 years. The ovulation factor (P = 0.02) and spouse's job (P = 0.05) were statistically significant difference between the groups. The score of self-efficacy and frequency of clinical pregnancy were no significant difference among three groups. Using linear regression, only the score of primary self-efficacy (before intervention) was in a significant relationship with self-efficacy after the intervention (P < 0.001). Conclusion: To our results, we recommend more research for assessing acupressure effects on self-efficacy and clinical pregnancy rate in infertile women

The Effect of Health Evolution Plan on the Performance Indicators in Hospitals of Mashhad University of Medical Sciences Using the Pabon Lasso Model

Background: Assessing the effectiveness and efficiency is one of the main issues in hospitals. Utilization of a hospital bed is important in determining the hospital's efficiency. The purpose of this study was to investigate the effect of Health Evolution plan on the performance indicators of hospitals affiliated to Mashhad University of Medical Sciences. Methods: This cross-sectional descriptive study was conducted in 22 hospitals of Mashhad University of Medical Sciences in 2013 and 2017 to investigate the effect of Health Evolution Plan. The study population included all hospitals (N = 28) affiliated to Mashhad University of Medical Sciences. The study samples consisted of 22 hospitals, which were active at the time of study.  The data were collected by referring to the statistical unit of the studied hospitals and extracting the functional indicators. Data analysis was performed using the Pabon Lasso chart in Excel software and SPSS 16. Furthermore, paired t-test was used to determine the relationship. Results: In 2013 and 2017, the highest bed occupancy rates were 86.55 and 94.27 %, respectively; whereas, the lowest rates were 48.20 and 54.21 %, respectively. The maximum numbers of bed turnover were 144.28 and 184.97 before and after the health evolution, respectively. However, the lowest rates were 7.45 and 8.85 before and after the health evolution, respectively. Moreover, the average daily hospital admission rates before the program were 40.10 and 6.33days in the studied years, respectively. After the plan, admission rates were 38.41 and 8.00 days in 2013 and 2017, respectively. The lowest admission rates before and after the plan were 1.51 and 1.41 days, respectively. A significant difference was observed between before and after implementation of plan regarding the percentage of bed occupancy, the average hospitalization period in days, and bed turnover (p < 0.05). Conclusion: After implementation of the Health Promotion Plan, favorable changes happened in the hospital status on the Pabon Lasso chart. Continuation of this program and its regular monitoring can improve the performance indicators of the hospitals

Factors Influencing Anxiety in Infertile Women Undergoing IVF/ICSI Treatment

Background & aim: Infertility can lead to a diminished sense of well-being and is associated with a high frequency of psychosomatic and somatic disorders. Generally, infertile women are more affected by infertility than men. This study aimed to determine factors influencing anxiety among infertile women undergoing in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Methods: This cross-sectional study was conducted on 224 infertile women who were candidate for IVF/ICSI referred to Milad IVF Center, Mashhad, Iran, from September 2015 to July 2016. Prior to the treatment, the participants completed the demographic characteristics questionnaire and Beck Anxiety Inventory (BAI) to assess the level of anxiety. Additionally, a self-structured questionnaire containing the infertility-associated data including the duration and cause of infertility as well as history and the duration of treatment, was completed by the respondents. The subjects were selected through purposive sampling technique. Data analysis was performed using Mann-Whitney U, Kruskal-Wallis, Fisher exact test, regression tests, as well as Spearman’s correlation coefficient in SPSS software, version 16.   Results: The results obtained from BAI showed that 38.4% of the subjects had moderate anxiety. There was a significant relationship between the level of anxiety and age (P=0.001), the cause of infertility (P=0.007), and the duration of treatment (P=0.001). Conclusion: As the level of anxiety was higher in infertile women with younger age, female factor infertility and longer duration of treatment, it is recommended to consider this population more vulnerable and to provide them supportive counseling to be able to overcome their anxiety

Epidemiology and clinical study of phenylketonuria (PKU) patients in Khorasan Province; Norteast Iran

Epidemiology and clinical study of phenylketonuria (PKU) patients in Khorasan Province; Norteast Iran Background: Phenylketonuria is an autosomal recessive disease. Early diagnosis is a important public health intervention to prevent neurological impairment .This study was designed to describe characteristics of phenylketonouria patients in Khorasan ,Northeast of Iran. Methods: We included all patients suffering from PKU in khorasan until September 2013. We gathered the variables like diagnosis age , sib of parents, cause of asking physician and screening based diagnosis or clinical based diagnosis. We use descriptive statistics for analysis. Results: The mean age of diagnosis was 19 months .80% pku patients had a positive history of consanguineous marriage in their parents. Incidence of new cases that identified by screening in 2012-2013 was 57 per 1000000 live birth. 10% patients identified with screening in first week of birth. Conclusion: Nearly all of our patients (90%) had been diagnosed without screening in the first days of their life only due to clinical manifestations in the first year of their life . According to efficacy of early diagnosis and dietary treatment, enforcement of public health policy for screening is a critical public health preventive intervention

Epidemiological and cost analysis of burned patients in Iran

Introduction: Considering the financial support provided by insurance and the government for burn patients in Iran, and recognizing the substantial economic impact associated with their treatment, there is a pressing need to delve into the epidemiology of these patients and analyze the related costs. This study aims to explore the epidemiological aspects and hospitalization costs of burn patients specifically within the burn ward of Imam Reza 68-bed Hospital in Mashhad, a regional center of referral in the eastern part of the country. Methods: Data had extracted from the electronic data collection system, which is used on a daily basis in the hospital. We included patients with a primary or secondary diagnosis of burns, code T20.0-T32.9 and T95 according to the International Classification of Diseases ICD-10. Ultimately, 1151 patients were included in the study. We analyzed 1151 burn cases in terms of patients’ age at the time of the event, gender, type of burn (Chemical, scalds, flame, electrical and contact burns), anatomical location of the burn (head and neck, upper limb, lower limb, multiple regions and part unspecified), burn etiology, burn degree (I, II, III), total burn surface area (%TBSA), Inpatient ward, expenditure ($), burn mortality rate and length of hospitalization. The age group was divided into seven groups by the 10 years intervals. Statistical analysis of the data was performed using SPSS-16 and Excel software. Results: 1151 patients were included in the study. High-risk groups are pediatric up to nine (0–9) years. According to age, we found that most cases were children, respectively, 25$9,365 ± $8,100 in pediatrics and$11,179 ± $10,180 in adults Conclusions: Most cases of death were related to burn in multiple areas of the body and then trunk burn (30% and 19%, respectively) and no death was observed in patients with hand and wrist burn. Burns can be incredibly severe and life-threatening, especially when they affect multiple areas of the body, such as the trunk and any burn injury is still a serious matter. It's important to prioritize fire safety and take precautions to prevent such accidents from happening