Deoxyribonucleic acid damage in Iranian veterans 25 years after wartime exposure to sulfur mustard

• Background: More than 100,000 Iranian veterans and civilians still suffer from various long-term complications due to their exposure to sulfur mustard (SM) during the Iran–Iraq war in 1983–88. The aim of the study was to investigate DNA damage of SM in veterans who were exposed to SM, 23–27 years prior to this study. • Materials and Methods: Blood samples were obtained from the veterans and healthy volunteers as negative controls. Lymphocytes were isolated from blood samples and DNA breaks were measured using single-cell microgel electrophoresis technique under alkaline conditions (comet assay). Single cells were analyzed with “Tri Tek Comet Score version 1.5” software and DNA break was measured based on the percentage of tail DNA alone, or in the presence of H2O2 (25 μM) as a positive control. • Results: A total of 25 SM exposed male veterans and 25 male healthy volunteers with similar ages (44.66 ± 6.2 and 42.12 ± 5.75 years, respectively) were studied. Percentage of the lymphocyte DNA damage was significantly (p < 0.01) higher in the SM-exposed individuals than in the controls (6.47 ± 0.52 and 1.31 ± 0.35, respectively). Percentages of DNA damage in the different age groups of 35–39, 40–44, 45–49, and 50–54 years in SM-exposed veterans (5.48 ± 0.17, 6.7 3 ± 1.58, 6.42 ± 0.22, and 7.27 ± 0.38, respectively) were all significantly (p < 0.05) higher than the controls (1.18 ± 0.25, 1.53 ± 0.22, 1.27 ± 0.20, and 1.42 ± 0.10, respectively). The lymphocytes incubated with H2O2 had much higher DNA damage as expected. The average of tail DNA is 42.12 ± 2.75% for control cells + H2O2 and 18.48 ± 2.14% for patients cells + H2O2; P < 0.001. • Conclusion: SM exposure of the veterans revealed DNA damage as judged by the comet assay

The Effect of Group Prenatal Care on Empowerment of Pregnant Adolescents: A randomized controlled trial

Objectives: This study aimed to evaluate the effect of group prenatal care on empowerment of pregnant adolescents. Methods: In this randomized controlled trial, 294 pregnant adolescents (aged 15-19) were randomly assigned into two groups of group prenatal care (GPNC, n=147) and individual prenatal care (IPNC, n=147). GPNC group received 5 sessions of GPNC (90-120 min) during 16-20 weeks of pregnancy, while the control group received individual prenatal care. The empowerment of participants in the two groups was measured using the empowerment scale for pregnant women. Data were analyzed using the Chi-square test, independent t-test, and adjusted regression test. Results: The mean total score of pregnant women’s empowerment in the GPNC and IPNC groups after the intervention was 86.46±4.95 and 81.89±4.75, respectively [ β= 6.11, 95% CI: 4.89, 7.33, p&lt;0.0001]. The improvement of dimensions of pregnancy empowerment in GPNC versus IPNC was as follows: Self‐efficacy: 18.21 ± 2.12 vs. 16.19 ± 1.79 [β= 2.52, 95% CI: 2.19, 2.86, p&lt;0.0001], Future image: 19.57±1.57 vs. 18.95±1.54 [β= 0.67, 95% CI: (0.44, 0.9], Self-esteem: 21.79 ± 1.75 vs. 20.90 ± 1.85 [β= 0.69, 95% CI: 0.41, 0.97, P&lt;0.0001], Joy of an addition to the family: 13.13±1.69 vs. 12.84±1.40 [β= 0.51, 95% CI: 0.28, 0.74, P=0.009], and Support and assurance from others: 13.70 ± 1.1 and 13.04 ± 1.07, [β= 0.76, 95% CI: 0.13, 1.65, P&lt;0.0001]. Conclusion: Group prenatal care can improve adolescent pregnant women’s empowerment. Results of the present study can serve as a useful foundation for implementing the group prenatal care model in Iran. Keywords: Adolescent pregnancy; Empowerment; Centering prenatal care; Group prenatal care; Ira

INVESTIGATING EFFECT OF NURSING INTERVENTIONS, BASED ON WELLS SCORE RESULTS, ON THE INCIDENCE OF DEEP VEIN THROMBOSIS IN PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT

 Objective: Venous thromboembolism, including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common complaint in critically ill patients. Therefore, the present study was conducted to determine the effect of nursing interventions, based on the Wells results, on the incidence of DVT in intensive care unit (ICU) patients.Methods: The present clinical trial was conducted on 72 ICU patients without DVT and PE who met the inclusion criteria according to Wells score in Dr. Ganjavian Hospital, Dezful in 2012. The participants were investigated and randomly divided into intervention (n=36) and control groups (n=36). The intervention group received preventive nursing measures based on the risk level determined by the Wells score, and routine therapeutic interventions were performed for the control group. Then, patients were evaluated using Wells score, D-dimer testing, and Doppler sonography on the 1st, 5th, and 10th days. Data were finally coded and entered into SPSS version 23. Data analysis was performed using Chi-square, Fisher's exact, and Mann–Whitney U tests.Results: The incidence of DVT in both groups showed that 2 patients of the control group who were identified to be at risk using the Wells score were diagnosed with DVT while none of the patients of the intervention group experienced DVT. The present study showed that 22.2% of the patients of the control group suffered from non-pitting edema, which was significantly different from the intervention group (p=0.005).Conclusion: The results of the present study showed that using the Wells score for early identification of the at-risk patients and nursing interventions based on this score's results is helpful in the prevention of DVT. Appropriate nursing interventions were also effective in reducing the incidence of non-pitting edema in the lower extremities

Effects of SP6 and ST36 Acupressure on Pain and Physiological Indexes in Addicted Men: A Single-Blind Randomized Clinical Trial

Background: Pain is the most crucial reason to seek treatment, and acupressure is one of the most common ways to relieve pain; therefore, this study was conducted with the aim to investigate the effectiveness of acupressure on the reduction of pain and stability of physiological indexes in addicted men. Methods: The present single-blind, randomized, clinical trial was performed on 90 participants who were hospitalized in an addiction treatment camp in Masjed-e-Soleyman, Iran. The participants were divided into acupressure group (n = 45) and control group (n = 45) through allocating permutation blocks method. The acupressure group received acupressure on SP6 and ST36 points for 3 consecutive sessions and each session for 10 minutes. The data collection tools used included a demographic information questionnaire, the Short-Form McGill Pain Questionnaire (SF-MPQ), and a physiological index registration form, tympanic thermometer, sphygmomanometer, pulse oximetry device, and digital watch. Repeated measures ANOVA was used to analyze the data. P ≤ 0.05 was considered statically significant. Findings: There was a statistically significant decrease in the sensory dimension of pain in the acupressure group compared to the control group in all 3 sessions (P ≤ 0.001; P ≤ 0.001; P = 0.001, respectively). There was no statistically significant difference in the overall pain score (P ≥ 0.005), emotional pain dimension (P ≥ 0.005), and physiological indexes of pain (P ≥ 0.005) between the two groups after the intervention. Conclusion: Acupressure is a non-invasive and cost-effective method that reduces the sensory dimension of pain, and its application does not require special tools; thus, the use of such a safe and secure method for relieving pain is recommended

The Effects of Tailored Energy Preservation Training on Fatigue and Re-admission in Patients with Heart Failure: A Randomized Clinical Trial

Background: Fatigue and re-admissions are the important consequences of heart failure that cause limitations in patients’ daily activities, personal, and social affairs. Energy conservation techniques are among evidence-based and non-pharmacological approaches that can reduce fatigue in patients with chronic disease.      Aim: The present study was performed with aim to determine the effects of tailored energy conservation training on fatigue and readmissions of patients with heart failure (HF).Method: This randomized clinical trial study was performed from May 2019 to March 2020 on 96 patients with HF admitted to CCU and cardiovascular clinics affiliated to Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Patients who met the inclusion criteria were randomly assigned to the intervention and control groups. A three-part tool (demographic-clinical questionnaire and need assessment), the Fatigue Severity Scale (FSS) and a readmissions record checklist were used to collect data. After determining the training needs of each individual, the intervention group received five 45-minute face-to-face individual training sessions of energy conservation strategies reinforced by telephone support every two weeks and followed up for 12 weeks. The control group only received routine post-discharge training. Fatigue scores by FSS and the readmissions recorded were tested at baseline and three months after the end of the intervention.Results: At baseline, the two groups were comparable in the mean hospital admissions and fatigue scores. However, after the intervention, the mean frequency of hospital admissions and the mean fatigue score were significantly lower in the intervention group (1.36±1.26, P< 0.001; 2.86±1.01,P< 0.001) than in the control group (0.42±0.77, P< 0.001; 5.25±1.03, P< 0.001) respectively.Implications for Practice: Nurses and physicians are recommended to teach energy conservation methods to patients with HF and chronic conditions who are prone to fatigue and its side effects

Psychometrics and Validation of the Intensive Care Unit Memory Assessment Tool in the Iranian Population

Background: The intensive care unit memory (ICUM) assessment tool is a practical tool for memory monitoring after the discharge from ICU. Objectives: This psychometric study purported to validate ICUM for a sample population of Iranian patients hospitalized in ICU. Materials & Methods: This research was a descriptive-analytical study that was conducted at Ahvaz University of Medical Sciences in 2022. A total of 96 patients were selected through the convenience sampling method and were asked to complete the questionnaire 2 weeks and 8 weeks after their discharge from the hospital. Exploratory factor analysis was run to validate the tool’s structure. The reliability of the ICUM tool was checked by the testretest method and the Cronbach alpha coefficient for memory subscales. Results: To increase the qualitative face and content validity of the tool in Persian, some vague items were modified according to the suggestions of the participants, language, and nursing experts. For the quantitative face validity, the item coefficient was calculated, and the minimum score obtained was 4.4. For the quantitative content validity, the content validity ratio (CVR) and content validity index (CVI) were calculated. The minimum obtained scores were CVI=0.7 and CVR=0.6. Thus, all the items were confirmed. The implementation of the factor analysis was confirmed with KMO=0.65. The highest Cronbach alpha coefficient for delusional memory was 0.62 and the highest test-retest correlation for factual memory was 0.95. Conclusion: The Persian version of ICUM has strong test-retest reliability, but weak internal consistency reliability. It is recommended that future studies evaluate the tool’s reliability over an extended period

The effectiveness of Mindfulness Based on Cognitive Therapy (MBCT) on quality of life and optimism of adolescent pregnant women

Background: Pregnancy during adolescence causes a person to face many challenges, so that its contradiction with the adolescent's identity structure can have negative effects on her psychological dimension, especially on optimism and quality of life. Since the health of the pregnant mother is one of the health priorities of any country, the present study aimed to investigate the effectiveness of mindfulness (MBCT) on the quality of life and the optimism of adolescent pregnant mothers. Methods: The present study was performed as an interventional study with a pre-test-post-test design on 88 adolescent pregnant women referring to health centers in Ahvaz. Participants were divided into 44 groups of intervention and control. For the intervention group, 8 sessions of 90-minute mindfulness counseling were held weekly. The control group also received routine pregnancy care. Participants completed the LOT-R and SF-36 quality of life questionnaires before and after the intervention. Data were analyzed by SPSS26 software. Findings: There was a significant difference in the overall quality of life between the control and experimental groups before and after the intervention (p &lt;0.001).&nbsp

Predicting the Probability of Phlebotomus papatasi Presence in Khuzestan Province: Combining Hierarchical Analysis Process and Geographic Information System

Background and purpose: Khuzestan Province in Iran is one of the endemic foci of zoonotic cutaneous leishmaniasis (ZCL) caused by Leishmania major and Phlebotomus papatasi as the main vector. The aim of this study was to predict the probability of presence of Ph. papatasi in this province using Hierarchical Analysis Process (AHP) and Geographic Information System (GIS). Materials and methods: In order to determine the distribution of Ph. papatasi, sand flies were collected in five counties, including Izeh, Mahshahr, Ahvaz, Dasht-e-Azadegan, and Andimeshk by sticky paper traps in spring and summer, 2018. Six criteria, including average annual temperature, average annual rainfall, average annual relative humidity, land use, soil texture, and elevation were selected. Maps of criteria were prepared in ArcGIS 10.5 software. The weights of the criteria and sub-criteria were determined using Expert Choice 11. Then, the final map of the probability of vector presence was prepared by combination of weighted maps and including the weight of the criteria. Results: In this study, 13 species of sand flies of two genera, Phlebotomus and Sergentomyia, were collected. The abundance of Ph. papatasi from samples collected in Izeh, Dasht-e-Azadegan, Mahshahr, Andimeshk, and Ahvaz was 55%, 72%, 69.4%, 3%, and 66.5%, respectively. Based on the analysis of matrix tables, average annual temperature (0.406), average annual relative humidity (0.233), and average annual rainfall (0.156) had the highest weight in probability of the vector presence, respectively. Conclusion: This study provides useful information for health authorities in determining the distribution of Ph. papatasi to act properly based on facilities and budget in case of outbreak

Multiple zoonotic helminth infections in domestic dogs in a rural area of Khuzestan Province in Iran

Abstract Background Echinococcosis and toxocarosis caused by the genus of Echinococcus and Toxocara spp. are among important helminthic diseases worldwide. Limited data on the prevalence of these parasites persuaded us to determine the prevalence of E. granulosus, E. multilocularis, and T. canis infections in domestic dogs in rural areas of Ahvaz, southwestern Iran. Fecal samples from 167 domestic dogs were examined using both microscopy and PCR techniques. Multiplex PCR was performed for the presence of Echinococcus, and Taenia spp. and single PCR for detection of T. canis and Toxascaris leonina. Results The total occurrence of identified parasites was 65 (38.9%). The microscopic examinations showed that 40 (24%), 18 (10.8%), and four (2.4%) of dogs were infected with taeniid-like, ascarid, and both genera eggs, respectively. Echinococcus granulosus was identified in seven (4.2%), Taenia spp. in 29 (17.4%), and mixed infection with both in 11 (6.6%) samples. Sequencing of PCR-positive samples identified E. granulosus s.s. (G1), 18 T. hydatigena (10.8%), five T. multiceps (3%), three T. serialis (1.8%), one T. ovis (0.6%), one Spirometra erinaceieuropaei voucher (0.6%), and two Mesocestoides corti (1.2%). This is the first report of S. erinaceieuropaei voucher and M. corti in dogs in Iran. Nine (5.4%) and 16 (9.6%) dogs showed infection with T. canis and T. leonina, respectively. Two samples showed coinfection with both ascarids. Conclusions Several studies have reported echinococcosis and toxocarosis in intermediate hosts from the southwest of Iran; however, this study is the first molecular research on E. granulosus and T. canis in domestic dogs in a rural area of southwestern Iran. Furthermore, issues of soil contamination with dogs’ feces and recent dust storms in Khuzestan may have a role in the spreading of these zoonotic infections to other provinces close to it, and neighboring countries such as Iraq