Agreement between DSM-IV and ICD-10 criteria for opioid use disorders in two Iranian samples

The aim of this study was to determine the agreement between the two systems in opioid users in the general population and a clinical sample. Two series of data were used in this study. The first was the data of 236 home-residing opioid abusers aged 15-64, who had previously participated in the Iran Mental Health Survey (IranMHS) in 2011, and the second was the data of 104 general psychiatry patients from inpatient or outpatient wards of two psychiatry hospitals in Tehran. Opioid use disorders were evaluated with CIDI-version 2.1. The disorders were assessed in all participants who used opioid substances for at least 5 times during the past 12. months. In the sample from the general population, the agreement between the two systems on the diagnosis of dependence was excellent (0.81). The agreement between the two systems on the diagnosis of abuse and harmful use was 0.41. In the clinical sample, the agreement between the two systems on the diagnosis of dependence or any opioid use disorder was 0.96 and 0.93, respectively. The agreement between abuse and harmful use was 0.9 and - 0.02 with and without regarding hierarchy, respectively. The inter-rater reliability of both DSM-IV and ICD-10 systems for all diagnosis was more than 0.95. The results of the diagnosis of dependence in the two systems had a weak concordance with treatment. The diagnostic criteria of DSM-IV and ICD-10 regarding dependence are very similar and the diagnosis produced by each system is concordant with the other system. However, the two systems have noticeable discrepancies in the diagnosis of abuse and harmful use. The discrepancies result from their conceptual differences and necessitate further revision in the definition of these disorders in the two systems. © 2013 Elsevier Ltd

Latent class analysis of symptoms for sexually transmitted infections among Iranian women: Results from a population-based survey

A preliminary symptom-based screening test would lower the financial burden of sexually transmitted infections (STIs) caused by clinical testing. To develop such a screening method, we should first identify the most specific STI symptoms. We aim to distinguish the specific STI symptom(s) that are most likely to be found in the truly infected individuals. We used data from a population-based survey that was conducted in Iran, in 2014. Using Latent Class Analysis (LCA) in R software, we classified 3049 Iranian women, 18�60 years old, with reference to seven self-reported STI-associated symptoms. Using LCA, we categorized nearly 1 of women as �probably STI-infected�. Above 70 of participants reported the �seven symptoms� that are associated with STIs, except for genital ulcer. These symptoms could be used to distinguish healthy participants from infected ones. The �probably healthy� class incorporated about 77 of the participants. Lower abdominal pain and abnormal vaginal discharge were the most frequently reported symptoms of this class. The LCA determined classes along with the WHO syndromic guidelines for STI diagnosis can help physicians to make a more accurate diagnosis. Hence, cost-effectively, only patients who are classified as probably infected need to be referred to medical laboratories for further investigations. © 2019, © 2019 Taylor & Francis Group, LLC

Investigation of Fungal Bioaerosols and Particulate Matter in the Teaching-Medical Hospitals of Khorramabad City, Iran During 2015

Background and Objective: The presence of fungal bioaerosols in hospitals indoor environments have affected the health of patients with the defect in immunity system. Therefore, determination of the rate and species of these agents is essential. This study aimed to investigate association between fungi contamination and particulate matter (PM10, PM2.5 and PM1) concentrations in the main indoor wards and outdoor environment and to determine I/O ratio in two educational-medical hospitals of Khorramabad City. Materials and Methods: In this description-analytical study, the concentration of fungal bioaerosols and particulate matter was measured in 10 indoor parts and 2 outdoor stations over 6 mounts. The sampling was conducted using Quick Take-30 at an airflow rate of 28.3 L/min and sampling period of 2.5 min onto Sabouraud dextrose agar medium containing chloramphenicol. The particulate matters were measured using Monitor Dust-Trak 8520. Moreover, the relative humidity and temperature were recorded using digital TES-1360. Results: Analysis of 288 fungi samples and 864 particulate matter samples showed that the average of fungi accumulation was 59.75 CFU/m3 and the mean concentrations of PM10, PM2.5 and PM1 in the indoor environment was&nbsp; 27.3, 23, and 20.2 &micro;g/m3 respectively. In addition, in ambient air the mean concentration was 135.3 CFU/m3 for fungal bioaerosols and 40.2, 35.7, and 29.8 &micro;g/m3 for PM10, PM2.5 and PM1 respectively. At the total of fungi samples, 12.5% were negative and 87.5% were positive. Having 101.7%, Infection ward was the most contaminated ward. The operation ward in both hospitals showed the minimum fungal contamination. Conclusions: The results of the present study showed that at all of the samplings the ratio of I/O was lower than one. It was noticed the dominancy of fungal bioaerosols and particulate matter of outdoor source on the indoor environment. In addition, a significant correlation (P < 0.001( was found between fungal bioaerosols frequency and particulate matter and as well as fungal bioaerosols frequency, relative humidity and temperature

Effects of cold application on chest tube removal pain in heart surgery patients

Background: Chest tube removal is considered a painful technique, which may not respond well to palliative therapies. There are no standard procedures or guidelines to manage the pain associated with chest tube removal. This study aimed to examine the effects of cold application on pain reduction during and after chest tube removal. Materials and Methods: This randomized controlled trial was conducted on 90 hospitalized patients, undergoing heart bypass surgery at the intensive care units where at least a pleural chest tube was inserted. The patients were randomly divided into two groups (45 samples per group). In the cold application group, an ice bag was placed at the designated point for 20 minutes before chest tube removal, while only routine interventions were applied for chest tube removal in the control group. Pain severity was measured in the groups before, during, and 15 minutes after chest tube removal, using the visual analogue scale. Repeated measures ANOVA test was applied for data analysis. Results: There was no significant difference in the baseline pain score between the groups (P= 0.18). However, there was a significant difference in terms of pain severity score between the cold application (3.58±1.09) and control (4.73±0.86) groups during chest tube removal (P< 0.001). On the other hand, there was no significant difference between the groups regarding the score of pain severity at 15 minutes after chest tube removal (P= 0.38). Conclusion: Cold application, as a nonpharmacological intervention, may contribute to the alleviation of cryotherapy-related pain. © 2018 NRITLD, National Research Institute of Tuberculosis and Lung Disease, Iran

Latent class analysis of DSM-5 criteria for opioid use disorders: Results from the Iranian National Survey on Mental Health

Background: Assessments of DSM-IV and DSM-5 criteria with sample populations of opioid users are limited. This study aimed to determine the number of latent classes in opioid users and assessment of the proposed revisions to the DSM-5 opioid use disorder (OUD) criteria. Methods: Data came from the 2011 Iranian National Mental Health Survey (IranMHS) on 7,886 participants aged 15-64 years living in Iran. We used the Composite International Diagnostic Interview (CIDI) version 2.1 in all respondents who indicated using opioids at least 5 times in the previous 12 months (n = 236). Results: A three-class model provided the best fit of all the models tested. Classes showed a spectrum of severity that was compatible with the DSM-5 classification. 'Legal problems' and 'desire to cut down' showed poor discrimination between classes. The weighted prevalence of OUD using DSM-5 was 20.7 higher than with DSM-IV. Conclusions: Results support the grouping based on severity of symptoms, combining abuse and dependence into a single diagnosis, omitting legal problems, and addition of craving as a new criterion. © 2015 S. Karger AG, Basel