Honey versus diphenhydramine for post-tonsillectomy pain relief in pediatric cases: a randomized clinical trial.

INTRODUCTION Tonsillectomy is one of the most common surgeries done worldwide and often the first one a child sustains. Pain relief after tonsillectomy is helpful for oral feeding after surgery. Acetaminophen and diphenhydramine have been conventionally used for reducing pain. This study was conducted to compare the effect of honey and diphehydramine on pain relief after tonsillectomy. MATERIALS AND METHODS For this randomized clinical trial study, 120 patients of 5 to 12 years undergoing tonsillectomy were recruited. The patients were divided into four groups randomly. After tonsillectomy and beginning of eating, Group A took 5cc honey alone every hour, Group B was given 5 cc 50% honey (mixed with water) every hour, group C was treated with 1mg/kg diphenhydramine every 6 hours and group D was observed without any intervention. In all patients, severity of the pain was evaluated by ocher questionnaire at recovery, and 3, 6, 12 and 24 hours after surgery. The data were analyzed using ANOVA and the repeated measures ANOVA (SPSS version 17). RESULTS The repeated ANOVA showed a significant decreasing trend of pain scores during the study for both pain scales (p 0.05). No statistically significant difference in pain was detected among the groups. CONCLUSION Although honey can help the pain decrease, more research is supported for confirmation of this effect

Joint prediction of occurrence of heart block and death in patient with myocardial infarction with artificial neural network model

When it is desired to examine occurrence of two events simultaneously, it is common to use bivariate statistical models such as bivariate logistic regression. Due to the limitations of classical methods in real situations, other methods such as artificial neural networks (ANN) are concerned. The aim of this study was comparing the predictive accuracy of bivariate logistic regression and artificial neural network models in diagnosis of death occurrence and heart block in myocardial infarction patients. Material and Methods: In this study, data was taken from a census in a cross-sectional study in which 263 patients with myocardial infarction cases who admitted to Hajar hospital heart care in 2013 to 2014. Gender, type of stroke, history of diabetes, previous history of hypertension, lipid disorders, history of heart disease, cardiac output fraction, systolic blood pressure, diastolic blood pressure, fasting and non-fasting blood sugar, cholesterol, triglycerides, low-density cholesterol, smoking, type of treatment, the troponin enzymes and insurant type were considered as explanatory variables and occurrence of death and heart block were used as dependent variables. Bivariate logistic regression and neural network model was fitted. Both models were predicted and the accuracy of them were compared. Models were fitted by MATLAB2013a and Zelig in R3.2.2. Results: Predictive accuracy of bivariate logistic regression model was 77.7% for the training and 78.48% for the test data. In ANN model, LM and OSS algorithms had best performance with 83.69% and 83.15% predictive accuracy for training data and 84.81% and 83.54% for testing data, respectively. Conclusion: This research showed that the neural network method is more accurate than bivariate logistic regression to joint predicting the occurrence of death and heart block in patients with myocardial infarctio

Effective factors on the number of decayed and filled teeth using the Conway-Maxwell-Poisson count model

BACKGROUND AND AIM: Recognizing the factors affecting the number of decayed and filled teeth has a major role in oral health. Dental data usually suffer from over-dispersion and excess zero frequencies. The purpose of this study was to use the Conway-Maxwell-Poisson (COM-Poisson) model to determine some of the factors affecting the number of decayed and filled teeth. METHODS: In this cross-sectional study, a sample of 1000 people from a cohort study in Shahrekord City, Iran, aged 35-70 years, was selected through systematic sampling. The data were analyzed using the Bayesian approach through Markov chain Monte Carlo (MCMC) simulation by OpenBUGS. Zero-inflated Poisson (ZIP), COM-Poisson model, and zero-inflated Com-Poisson (ZICMP) model were fitted on the data and compared using the deviance information criterion (DIC). RESULTS: The mean numbers of decayed and filled teeth were 0.77 ± 1.63 and 4.37 ± 4.62, respectively. The Com-Poisson and ZICMP showed to be better fit for the number of decayed and filled teeth, respectively. Those people who were younger, male, smokers, diabetics, did not floss, and did not use mouthwash had significantly more number of decayed teeth (P < 0.05). Those people who were younger, female, non-diabetics, non-smokers, employed, literate, had less body mass index (BMI), flossed, and got higher score of quality of life had significantly more number of filled teeth (P < 0.05). CONCLUSION: By controlling such factors as education, BMI, flossing, using mouthwash, smoking, diabetes, and quality of life, we could improve the oral health. KEYWORDS: Bayes’ Theorem; Conway-Maxwell-Poisson Distribution; Decayed, Missing, and Filled Teeth; Zero-inflate

Psychometric properties of the Postgraduate Hospital Educational Environment Measure in an Iranian hospital setting

Background: Students’ perceptions of the educational environment are an important construct in assessing and enhancing the quality of medical training programs. Reliable and valid measurement, however, can be problematic – especially as instruments developed and tested in one culture are translated for use in another. Materials and method: This study sought to explore the psychometric properties of the Postgraduate Hospital Educational Environment Measure (PHEEM) for use in an Iranian hospital training setting. We translated the instrument into Persian and ensured its content validity by back translation and expert review prior to administering it to 127 residents of Urmia University of Medical Science. Results: Overall internal consistency of the translated measure was good (a=0.94). Principal components analysis revealed five factors accounting for 52.8% of the variance. Conclusion: The Persian version of the PHEEM appears to be a reliable and potentially valid instrument for use in Iranian medical schools and may find favor in evaluating the educational environments of residency programs nationwide

A Study of Social Health Status in the Population of the Prospective Epidemiological Shahrekord Cohort Study in Chaharmahal and Bakhtiari Province in 2019

Background and aims: Social health refers to the quantity and quality of interaction of an individual with society to promote the well-being of individuals in the society. This interaction promotes social capital and social security, and reduces poverty and injustice. So far, no study has been ever done on the social health situation in Chaharmahal and Bakhtiari province. This study aimed to investigate the social health status in Chaharmahal and Bakhtiari province in 2019. Methods: In this cross-sectional and descriptive-analytical study, the data from the prospective epidemiological study of Shahrekord cohort study in Chaharmahal and Bakhtiari province in 2019 were used. In order for measuring social health, a valid Iranian social health questionnaire with a score range of 33-165 was used. ANOVA and t test in SPSS version 22 were employed for analyzing the data in order to compare the mean values.Results: By way of explanation, 597 individuals out of 600 samples completed the social health questionnaire (99.5 response rate). The mean ± standard deviation age of participants was 48.54±9.33 years and the mean ± standard deviation score of their social health was 115.71±22.7. This score was higher in men than in women (P = 0.038). Social health score was significantly higher in urban areas than in rural areas (P = 0.001). Social health was highest in civil servants, and lowest in unemployed participants (P = 0.001). Social health score was lower in obese and high body mass index (BMI) individuals than in normal BMI individuals (P = 0.047).Conclusion: Social health in the studied population was moderate and, therefore, deserves the attention of health policy makers and planners. Social health can be improved by holding training classes for villagers and teaching them how to interact with each other � especially with family members, furthering participation of women in social affairs and increasing their social relationships, giving advice on diets and social health to people with non-normal BMI, as well as by holding post-retirement training classes for retirees

An Analysis of Policies of the Iranian Health Care System in Relation to the Nursing Profession

Introduction: The present study was a part of the findings of a qualitative thematic content analysis aimed at elucidating the role and position of nursing from the viewpoint of the managers of the Iranian health care system. The theme of inappropriate policies of the health care system, which was extracted in the analysis, was evaluated in this research. The results of this study are part of an effort to develop the nursing education model based on the determination of the role and position of nursing in the health care system. Method: In this study, qualitative thematic content analysis was used. Through purposive sampling, 6 managers and experts in the health care system were selected as participants. The structured interview was used for data collection. Results: In relation to the theme of inappropriate health care policy in relation to the nursing profession, a total of 5 categories and 14 subcategories were extracted. Conclusion: The Iranian health care system has witnessed profound changes in the last decade. However, it is faced with many challenges in the subsystem of nursing. Iran's health care policy in relation to the nursing profession is inadequate. It seems that the lack of dialogue between nursing and other health care institutions, unwillingness of these institutions to recognize nursing, and lack of involvement of nurses in policies because of conflicts of interest are effective factors in this regard. Uncertainty about the scope of services in the field of nursing care, training of disciplines parallel with nursing, non-discrimination in the provision of services within nursing, incompatibility of nursing services and payment, lack of attention of the health care system to the importance of nursing services, and placing professional nursing responsibilities as second priority in comparison with nonprofessional and unrelated responsibilities such as accreditation were the findings of this analysis. Keywords: Health care policy, Health care system, Nursing professio

Determination of the effect of self-care based on the need for quality of life in people with AIDS

Introduction: Considering the prevalence of acquired immunodeficiency virus infection and the need to strengthen programs for improving quality of life, the present study was conducted to examine the effect of self-care based on the need for quality of life in people with acquired immunodeficiency syndrome (AIDS). Material and methods: In a clinical trial study, 66 human immunodeficiency virus (HIV)-positive patients referred to Navab Safavi Hospital in Isfahan were assigned to two intervention and control groups randomly. The first group was placed under the intervention of self-care program and no intervention was performed in the second group. The quality of life score of patients before and after the intervention in the two groups was examined and compared. Results: The mean quality of life score in the intervention group was 68.7 +/- 11.8 before and reached 79.7 +/- 10.3 after intervention, which was statistically significant (p = 0.002). In the control group, the mean quality of life scores before and after treatment were 65.7 +/- 11.9 and 60.8 +/- 11.7, respectively, which was not statistically significant (p = 0.053). Also, the change in the quality of life score was statistically significant (p < 0.001) between case and control groups. Conclusions: Providing self-care programs in patients with HIV leads to an increase in the quality of life in them. Since these patients are at risk for various types of psychiatric disorders, they must be mentally and emotionally supported and should be encouraged to improve their quality of life by promoting their own self-care programs. Medical science and doctors may find the findings useful in their medical experience and practice. Keywords Author Keywords:self-care; quality of life; acquired immune deficiency viru

Oxford-MEST classification in IgA nephropathy patients: A report from Iran.

BACKGROUND There is a limited knowledge about the morphological features of IgA nephropathy (IgAN)in the middle east region. OBJECTIVES The objective of this study was to evaluate the spectrum of histopathological findings in IgAN patients at our laboratory. PATIENTS AND METHODS At this work, an observational study reported which was conducted on IgAN patients using the Oxford-MEST classification system. RESULTS In this survey, of 102 patients 71.6 % were male. The mean age of the patients was 37.7 ± 13.6 years. Morphologic variables of MEST classification was as follows; M1: 90.2 %, E: 32 %, S: 67 % also,T in grads I and II were in 30% and 19% respectively, while 51% were in grade zero. A significant difference was observed in segmental glomerulosclerosis (P=0.003) and interstitial fibrosis/tubular atrophy frequency distribution (P= 0.045), between males and females . Furthermore, it was found that mesangial hypercellularity was more prevalent in yonger patients. Moreover, there was a significant correlation between serum creatinine and crescents (P<0.001). There was also significant correlation of serum creatinine with segmental glomerulosclerosis (P<0.001). CONCLUSIONS Higher prevalence of segmental glomerulosclerosis and interstitial fibrosis/ tubular atrophy, as the two of, four variables of Oxford-MEST classification of IgAN in male patients further attests that male gender is a risk factor in this disease.In this study the significant correlation between serum creatinine and crescent was in an agreement with previous studies and suggests for the probable accomodation of extracapillary proliferation as a new variable in MEST system

Non-communicable diseases in the southwest of Iran: profile and baseline data from the Shahrekord PERSIAN Cohort Study

Background Critical inter-provincial differences within Iran in the pattern of non-communicable diseases (NCDs) and difficulties inherent to identifying prevention methods to reduce mortality from NCDs have challenged the implementation of the provincial health system plan. The Shahrekord Cohort Study (SCS) was designed to address these gaps in Chaharmahal and Bakhtiari, a province of high altitude in the southwest of Iran, characterized by its large Bakhtiari population, along with Fars and Turk ethnicity groups. Methods This ongoing cohort, a prospective, large-scale longitudinal study, includes a unique, rich biobank and was conducted for the first time in Chaharmahal and Bakhtiari Province in Iran. SCS is a part of the PERSIAN (Prospective Epidemiological Research Studies in IrAN) cohort. The study began in 2015, recruited 10075 participants (52.8% female, 47.2% male) from both urban (n=7034) and rural (n=3041) areas, and participants will be annually followed up for at least 15 years. A cross-sectional analysis was conducted using baseline data from the SCS, using descriptive statistics and logistic regression. Data analysis was performed using Stata software. Results The prevalence of NCDs was 9.8% for type 2 diabetes, 17.1% for hypertension, 11.6% for thyroid disease, 0.2% for multiple sclerosis and 5.7, 0.9 and 1.3% for ischemic heart disease, stroke and myocardial infarction, respectively. The prevalence of multimorbidity (>= 2 NCDs) was higher in women (39.1%) than men (24.9%). The means (standard deviations) of age, BMI, systolic blood pressure and fasting blood glucose were 49.5 (9) years, 27.6 (4.6) kg/m(2), 115.4 (17.3) mmHg and 96.7 (27.3) mg/dL, respectively. Logistic regression models showed that older age, female gender, living in an urban area, non-native ethnicity, high wealth index, unemployment, obesity, low physical activity, hypertriglyceridemia, high fasting blood sugar, alkaline urine pH and high systolic and diastolic blood pressure were associated with increased prevalence of NCDs. Conclusions The SCS provides a platform for epidemiological studies that will be useful to better control NCDs in the southwest of Iran and to foster research collaboration. The SCS will be an essential resource for identifying NCD risk factors in this region and designing relevant public health interventions