Potentially inappropriate medication prescribing based on 2019 Beers criteria and the impact of pharmacist intervention in elderly patients with kidney diseases:A report from Iran

Background and Aims: A potentially inappropriate medication (PIM) is a pharmaceutical agent that poses a greater risk of harm than potential benefit to elderly patients. This study aimed to detect PIMs and their risk factors in hospitalized elderly patients with kidney disease. Methods: This cross-sectional study assessed medication orders of elderly patients (≥65 years old) with kidney diseases admitted to the hospital. In the first 6 months, we retrospectively evaluated all medications to identify PIMs according to the 2019 Beers criteria. In the second phase, a clinical pharmacist prospectively evaluated all medications and suggested modifications as needed. Data were analyzed to determine risk factors for prescribing PIMs. Results: Based on our evaluation of 258 patients, we observed that the utilization of PIMs was prevalent among the study population. Of the total patients evaluated, 273 instances of PIM use were identified, with only 23.3% of patients not having any PIMs. Notably, proton pump inhibitors and benzodiazepines were the most frequently prescribed PIMs. The risk of experiencing a PIM was significantly amplified by a higher degree of polypharmacy, with odds approximately 2.68 times higher (p &lt; 0.01). Several factors were found to be associated with an increased likelihood of having a PIM, including being male, undergoing hemodialysis, having chronic kidney disease or other comorbidities, and having an extended hospital stay. The second phase of study, in terms of addressing these issues, physicians adhered to 67.5% of the 120 recommendations made by pharmacists regarding the discontinuation of PIM usage. Conclusion: High prevalence of PIMs was detected in our study population. Preventing medication-associated harms in the elderly can reduce the financial burden imposed on healthcare systems. Therefore, routine evaluation of medications with clinical pharmacists and/or implementation of computerized medication decision support systems is recommended to prevent PIMs use.</p

Potentially inappropriate medication prescribing based on 2019 Beers criteria and the impact of pharmacist intervention in elderly patients with kidney diseases:A report from Iran

Background and Aims: A potentially inappropriate medication (PIM) is a pharmaceutical agent that poses a greater risk of harm than potential benefit to elderly patients. This study aimed to detect PIMs and their risk factors in hospitalized elderly patients with kidney disease. Methods: This cross-sectional study assessed medication orders of elderly patients (≥65 years old) with kidney diseases admitted to the hospital. In the first 6 months, we retrospectively evaluated all medications to identify PIMs according to the 2019 Beers criteria. In the second phase, a clinical pharmacist prospectively evaluated all medications and suggested modifications as needed. Data were analyzed to determine risk factors for prescribing PIMs. Results: Based on our evaluation of 258 patients, we observed that the utilization of PIMs was prevalent among the study population. Of the total patients evaluated, 273 instances of PIM use were identified, with only 23.3% of patients not having any PIMs. Notably, proton pump inhibitors and benzodiazepines were the most frequently prescribed PIMs. The risk of experiencing a PIM was significantly amplified by a higher degree of polypharmacy, with odds approximately 2.68 times higher (p &lt; 0.01). Several factors were found to be associated with an increased likelihood of having a PIM, including being male, undergoing hemodialysis, having chronic kidney disease or other comorbidities, and having an extended hospital stay. The second phase of study, in terms of addressing these issues, physicians adhered to 67.5% of the 120 recommendations made by pharmacists regarding the discontinuation of PIM usage. Conclusion: High prevalence of PIMs was detected in our study population. Preventing medication-associated harms in the elderly can reduce the financial burden imposed on healthcare systems. Therefore, routine evaluation of medications with clinical pharmacists and/or implementation of computerized medication decision support systems is recommended to prevent PIMs use.</p

SIDO coupled inductor-based high voltage conversion ratio DC–DC converter with three operations

Abstract Here, a single‐input, dual output (SIDO) coupled inductor‐based high voltage conversion ratio DC–DC converter is proposed. The proposed converter has the capability of operating as a SIDO converter in a way that the terminal of the input voltage source is exchangeable among the three ports. Therefore, there are three different operation modes for the proposed converter. The voltage conversion ratios of the high voltage ports over the low voltage port can be improved by increasing the turn ratio of the coupled inductors. The main advantage of the proposed converter is achieving high voltage gains with lower number of components for the whole range of duty cycles comparing to the conventional multi‐port high voltage gain converters. Moreover, two output voltages of the proposed converter can be simultaneously regulated on different constant levels with a good precision. In this study, the voltage conversion ratios, the inductors’ average currents, the voltage and current stress on the switches are calculated theoretically. Finally, an experimental prototype of 30 V input and 410, 260 V outputs with the power 510 W is implemented and the results are verifying the theoretical ones

Investigation of Pediatric Brucellosis

Background and Aim: Brucellosis (also known as undulant fever, Mediterranean fever, or Malta fever) is a zoonotic infection transmitted to humans from infected animals (sheep, cattle, goats, pigs, camels, or other animals) by ingestion of food products (such as unpasteurized dairy products) or by contact with tissue or fluids.&nbsp; This disease occurs on average in 11 to 56 percent of children in endemic regions. Despite being long recognized and controllable, the disease still causes substantial morbidity, affecting especially the young population. The objective of this research was to examine the clinical, laboratory results of childhood brucellosis and brucellosis epidemiological features in patients up to 15&nbsp;years in the province in Pol-e Dokhtar city, Iran. Methods The diagnosis of brucellosis was established on the basis of clinical features, and positive results from Serologic evaluation included Wright test and the 2-mercaptoethanol (2ME) test. This information includes medical records of brucellosis patients in the years 2016 to 2019. SPSS software (version 22.0) was used for the data analysis. Results: Among the patients infected with Brucella, 19 males (70.37%) and 8 females (29.63%) were diagnosed and&nbsp; 11 patients (40.74%) were 5-9&nbsp;years of age, 10 patients (37%) were 10-15 years of age, and 6 patients (22.26%) were &lt; 5 year of age. Also 27 (100%) patients were from rural regions (the total of affected children) that confirmed direct contact with infected animals in all of them was already established. The most frequent seasons of disease occurrence were summer (33.38%) and winter (29.6%). Conclusion: Considering that 100% of the infection of children has been seen in those who lived in the village, it requires regular vaccination of livestock and proper training in the field of disease prevention. *Corresponding Authors: Faranak Rezaei, Email: [email protected]; Iman Pouladi, Email: [email protected] Please cite this article as: Babaei Z, Azizi abi F, Pouladi I, Rezaei F. Investigation of Pediatric Brucellosis in Pol-e Dokhtar city, Iran. Arch Med Lab Sci. 2020;6:1-4 (e14). https://doi.org/10.22037/amls.v6.3054

Genotyping of giardia duodenalis isolates in individuals with and without chronic diarrhea using polymerase chain reaction

Background and purpose: Giardia cyst and trophozoite have invariant morphologies, therefore, investigating aspects such as host specificity, transmission patterns and clinical behavior of the parasite in hosts requires molecular characterization of the parasites isolated from clinical samples. The aim of this study was to characterize giardiasis isolated from human fecal samples with symptomatic (with a history of chronic diarrhea) and asymptomatic giardiasis and investigating the correlation of parasite's assemblage with diarrhea. Materials and methods: Thirty one fecal samples containing Giardia cysts from individuals with symptomatic and asymptomatic giardiasis were used to characterize the parasites' genotype. Triose Phosphate Isomerase (TPI) gene was amplified by polymerase chain Reaction (PCR). Demographic information was recorded using a questionnaire and SPSS ver.16 and Fisher's exact test were applied to analyse the data. Results: PCR showed a higher frequency of Giardia duodenalis assemblage B compared with assemblage A (51.6 vs. 35.5). However, the frequency of Giardia duodenalis assemblage A in symptomatic giardiasis was significantly higher than that of the asymptomatic giardiasis (62.5 vs. 18.75). The Fisher's exact test revealed a significant correlation between Giardia doudenalis assemblage A and diarrhea (p<0.005). Conclusion: Usually, duodenalis assemblage A is accompanied by clinical symptoms such as diarrhea. However, duodenalis assemblage B is more prevalent among those with diarrhea

The Relationship Between Perceived Stress Level and Consumption of Fast Foods Among Female Students of Shahrekord University of Medical Sciences

the present research aimed to study the relationship between the consumption of fast foods with perceived stress level among female students of Shahrekord University of Medical Sciences. Methods: The present research was a cross-sectional descriptive-analytical study which was conducted on female students of different faculties and majors in Shahrekord University of Medical Sciences in the academic year 2016-2017. Out of the study population, 152 students were selected as the sample using random cluster sampling method. The required data were collected using a demographic information questionnaire , a standard 14-item scale for the measurement of perceived stress level, and a checklist to record the number of fast foods consumption (daily, weekly, and monthly). Finally, the data were statistically analyzed using descriptive and analytic tests in SPSS-18. Participation in the study was voluntary. Results: The results showed that 45.4% of students participated in this study aged 18-20, 16.4% of them were studying in General Hygiene, and 85.8% were a B.S. student. The mean score of perceived stress and fast foods consumption was 51.36±13.52 and 12.42±5.42, respectively. The results indicated that there is a significant relationship between age and perceived stress and also between mother’s educational attainment and perceived stress Conclusion: Considering the relationship between perceived stress and fast foods consumption in university students, it is necessary to apply effective patterns and theories of health education and promotion and also to pay attention to interpersonal and environmental factors in order to reduce stress and encourage healthy diets eating habits. Keywords Stress, Fast foods, University, Student, Health

Association between social cognitive theory constructs and fruit and vegetable's consumption in adolescent girls

Background: Unfortunately just a few numbers of children and adolescents use sufficient amounts of fruit and vegtabless. This study aimed to investigate the Association between social cognitive theory constructs and fruit and vegetables consumption in adolescent girls. Materials and Methods: This is a descriptive analytic study conducted on 308 high school girls (first grade) who were selected by cluster sampling method in Shahrekord, Chaharmahal and Bakhtiari province, Iran. A researcher made questionnaire was used to collect the needed data like demographic variables, substructures of perceived self-efficacy, outcome expectations and outcome evaluation. In order to investigate the fruit and vegetables consumption status, the standard questionnaire of Food Frequency Questionnaire (FFQ) was used. The data were analyzed using SPSS 18.0 software. Results: The mean scores of outcome expectation, outcome evaluation and perceived self-efficacy were 35.52±16.26, 34.60±20.21 and 32.55±19.81, respectively of the total score of 100. The mean scores of fruit and vegetables consumption and vegetables consumption were reported as 1.45±0.68 and 1.47±0.95, respectively, as well. There was a direct significant correlation between adolescents' perceived self-efficacy and outcome expectations (P = 0.034, r = 0.040). A direct significant correlation was also observed between fruit consumption and both outcome evaluation (P = 0. 033, r = 0.012), and perceived self-efficacy (P = 0.051, r =0.064). Conclusion: Regarding the status of fruit and vegetables consumption and the mean scores of social cognitive theory constructs and relationship between them and also the importance of promoting healthy diet in the critical period of adolescence, it seems necessary to use efficient patterns and theories of health education and promotion has been considered

The Relationship Between Perceived Stress Level and Consumption of Fast Foods among Female Students of Shahrekord University of Medical Sciences

Background and aims: Nowadays, with the advancement of science and technology, lifestyle has changed and fast foods are being commonly consumed. Due to their special circumstances, university students are susceptible to stress, anxiety, and bad nutritional patterns and, because of the consumption of high amounts of fat and salt and physical inactivity, are at increased risk of overweight and obesity. Therefore, the present research was conducted to study the relationship between the consumption of fast foods and perceived stress level among female students of Shahrekord University of Medical Sciences. Methods: The present research was a descriptive-analytical study conducted on female students of different faculties and majors in Shahrekord University of Medical Sciences in the academic year 2016-2017. From the study population, 152 students were selected as the samples using random cluster sampling method. Data were collected using a demographic information questionnaire (age, major, parents’ education level, education level, and place of residence), a standard 14-item scale for the measurement of perceived stress level, and a checklist to record the frequency of fast foods consumption in university and home or dormitory (daily, weekly, and monthly). Data analysis was conducted using descriptive and analytical tests (chi-squared, independent t test, and Spearman’s and Pearson’s correlation coefficients) in SPSS 18. Participation in the study was voluntary. Results: Results showed 45.4% of participants aged 18-20, 16.4% of whom were studying in public health, and 85.8% were BSc students. The mean scores of perceived stress and fast foods consumption were 51.36 ± 13.52 and 12.42 ± 5.42, respectively. There was a significant relationship between age and perceived stress (P = 0.000), and between mother’s education level and perceived stress (P = 0.011). There was no significant relationship between the mean score of perceived stress and fast foods consumption in participants (P = 0.072) Conclusion: Considering the level of perceived stress and fast foods consumption in university students, it is necessary to apply effective patterns and theories of health education and promotion and also to direct attention to interpersonal and environmental factors to reduce stress and encourage healthy eating habits

The Relationship Between Tendency to Computer Games and the Mental Health of Junior High School Students of Shahr-e Kord, Iran

Background and aims: Given that computer games have positive and negative functions and may affect the mental health of individuals, the present research aimed to study the relationship between the tendency to playing computer games and the mental health of junior high school students in Shahr-e Kord. Methods: The current cross-sectional descriptive-analytical study was conducted on 245 boy and girl junior high school students of Shahr-e Kord in 2016. The participants were selected using a random cluster sampling method. The required data were collected using questionnaires of demographic variables, the standard 28-item General Health Questionnaire, and an author-made questionnaire on the tendency to computer games. Finally, the data were statistically analyzed using descriptive and analytic tests in SPSS-18. Participation in the study was voluntary. Results: The results showed that 31.8% of the students aged 14 years old. In addition, the tendency to computer games was higher in girls (0.027) and their level of mental health was lower compared to boys (P = 0.032). There was a significant relationship between the tendency to computer games and the age of the students (P = 0.023). Eventually, age (P = 0.025) and gender (P = 0.09) represented a significant relationship with the mental health of the students. Conclusion: Based on the low level of mental health in girls, it is necessary to pay special attention to the symptoms of depression and anxiety and social functions in adolescents, control the time spent on playing the computer games, plan carefully for their leisure time, direct adolescents toward reading books, and promote their health using educational patterns. Keywords Computer games, Students, Mental health