سید محمد ریاحی

Given the medical conditions of hemodialysis patients, nutritional problems in these patients can impact their quality of life and mortality. This study aimed to investigate the prevalence of malnutrition in hemodialysis patients in Birjand.

The study was conducted in 2022 using a descriptive-analytical approach. A total of 115 hemodialysis patients from Birjand were recruited via purposive sampling. A demographic characteristics form, as well as the Subjective Global Assessment-Dialysis Malnutrition Score (SGA-DMS), were used to collect data in this study. Additionally, the patients’ anthropometric and biochemical measurements were made, and their connection to nutritional status was established.

Overall, 80 (69.6%) of the patients had normal nutritional status, while 35 (30.4%) had mild to moderate malnutrition. Patients with normal nutrition had higher levels of BUN, albumin, and CRP prior to hemodialysis than those with mild to moderate malnutrition. Moreover, in the patients with normal nutrition, the cholesterol level was lower. Patients with mild to moderate malnutrition exhibited lower levels of creatinine before and after hemodialysis and lower BUN after hemodialysis compared to the patients with normal nutrition.

The study indicates a lower prevalence of malnutrition compared to some other studies. However, the high prevalence of malnutrition underscores the importance of routine assessments and nutritional interventions by nutritionists for these patients.

The changes in the causes of death in South Khorasan province, Iran, during 2002-2022 were examined in the present research. According to the data available in the “Mortality Data Registery” during these 20 years, cardiovascular diseases (CVD) was the most common cause of death, and its rate has increased from 20% in 2002 to about 37.8% in 2022. Even during the COVID pandemic, CVD was the first cause of death in the province. In 2022, the most common causes of death were CVD (37.8%), respiratory diseases (15.2%), cancers (14%), and accidents (9.2%). One of the most effective factors in preventing CVD is paying attention to"Life’s essential 8 Cardiovascular Health", i.e., having normal blood glucose, blood pressure, serum lipids, body mass index, sufficient physical activity, healthy diet, sufficient night sleep, and being a non-smoker. In addition to individuals’ attention to these factors, it is necessary for healthcare system decision-makers to have systematic and continuous planning to enhance people's awareness and attitude regarding these eight factors.

COVID-19, caused by SARS-CoV-2 virus, raised global health concerns due to its rapid spread. During the fight against this epidemic, GIS and geographical information have played an important role in identifying the spatial transmission of this pandemic for control, prevention, and decision-making regarding the allocation of medical resources. This study aimed to investigate the spatiotemporal distribution and influential factors in the spread of COVID-19 in South Khorasan province using a geographic information system. This descriptive-analytical study examined the relationship between 12 descriptive variables, including elevation, average precipitation, average temperature, population, area, literacy rate, insurance coverage, unemployment rate, population density, number of people over 65, number of hospitals, and number of health centers, with the dependent variable of COVID-19 incidence at the study boundary, using Geographically Weighted Regression (GWR) and Ordinary Least Squares (OLS) regression. To this end, the Moran's spatial correlation test was used. The results showed that five variables had a significant correlation with the distribution of COVID-19 in the province. Population density, people over 65, and the number of hospitals had a greater impact compared to other variables. Based on the obtained results, this system can be useful in the management and control of the COVID-19 epidemic and can be used in pandemic diseases as well.

Intravenous immunoglobulin (IVIG) is one of the safest biological products, which is effective in the treatment of many diseases. This study aimed to evaluate the rational prescription pattern of IVIG based on the approved indications of the Food and Drug Administration (FDA) among teaching hospitals in Birjand, Iran.

This descriptive-analytical study included 300 patients receiving IVIG who were hospitalized in different wards of Razi and Vali-e-Asr hospitals in Birjand during 2016-19. Demographic characteristics, dose, duration of administration, duration of hospitalization, side effects, and other necessary information were extracted from patients' medical records. The collected data were compared with FDA-approved indications and dosages, followed by identifying the rate of rational prescription of the drug. The data were analyzed in SPSS software (version 19) through independent t-test (or Mann-Whitney) and Chi-square test to compare quantitative and qualitative variables in the groups, respectively.

According to the results, half of the patients were male (n=150; 150%). The mean age of the patients receiving IVIG was 28.17±27.01 years. Most of the patients receiving IVIG (30.3%) were hospitalized in the neurology ward. Guillain-Barre syndrome and immune thrombocytopenic purpura accounted for the most prescription of IVIG. In total, 133 patients (44.3%) (95%CI: 38.6-50.1) received the drug according to the FDA on-labeled indication. The dose of IVIG was rationally based on FDA in 33% of the cases (95%CI: 27.7-38.6).

Due to the limited availability and high price of this product, it is recommended to formulate and closely monitor the implementation of rational IVIG consumption in the hospital based on the regional standard protocol, especially with the presence of clinical pharmacists.

During epidemics of infectious diseases, individuals’ health, especially their mental health, are affected. This study aimed to evaluate general health and its dimensions during the COVID-19 epidemic in South Khorasan province, Iran.

This study is a cross-sectional study. Individual information was collected voluntarily on the web. General health evaluation was performed by a standard questionnaire (GHQ-28). The collected data were entered into the SPSS v.23 and statistical tests were performed.

This study was performed on 320 people, most of the subjects were in the age range of 20-30 years. Also, 80 (25.0%) participants reported nonspecific symptoms of COVID-19 such as headache, sore throat, and dry cough, and 216 people (67.5%) used personal protective equipment (PPE). The mean score of the GHQ-28 one month before the COVID-19 epidemic (BE) was 16.5 ± 9.1, while the mean of this score during the epidemic (DE) increased by 1.8 points and reached 18.3 ± 10.2 (P ≤0.003, effect size=10.9%). The score of anxiety/insomnia subscale showed the highest increment. Adjusted R2 values for the scores of somatic symptoms, anxiety/insomnia, and social dysfunction subscales, and the score of the GHQ-28 were 14.8%, 10.5%, 13.8%, and 13.1%, respectively.

This study showed that with the COVID-19 epidemic, the community has been faced with conditions in which individualschr anxiety, depression, social function, and in general, various dimension of health, has been deteriorated. The results of this study can be beneficial for appropriate planning for maintaining, promoting, and improving health in the community.

Anemia is one of the most important nutritional disorders among children and adolescent in Iran and developing countries. Despite the possibility of anemia prevention, there is a high proportion of this problem in school children and especially infants. The aim of this study was to determine the prevalence rate of anemia in 6 to 12 months old children. This was a cross-sectional study that conducted between May 2016 and October 2016 in Tabas health centers, South Khorasan, Iran. In this study 911 infants aged 6 to 12 months were enrolled by census method. Demographic variables and all blood factors were collected through interviews and laboratory tests in Tabas health centers, respectively. In this study, cut-off point of <11 g/dl for hemoglobin was considered as anemia index. All Statistical analyses were done using descriptive statistics, chi-square tests and Pearson correlation in SPSS software, version 22 (SPSS Inc., Chicago, IL, USA). P-value of 0.05 was considered as level of statistical significance. The mean age of individuals was 9±1.5 months, the mean current weight and the mean weight at birth time were 8678±1112.1 g and 3090±467.9 g, respectively. According to World Health Organization (WHO) criteria, the prevalence rate of anemia in Tabas City was estimated 37.1%. The prevalence rate of anemia in age groups based on hemoglobin, mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) indices had a significant decreasing trend (P=0.001). Prevalence rate of anemia in males and females was not significantly different (P=0.27). Moreover prevalence rate of anemia was higher in rural areas rather than urban areas (P=0.009). This is the first assessment of anemia prevalence among children in east of Iran. As a result of estimated prevalence of anemia, based on WHO definition, revealed moderate public health importance among infants aged 6 to 12 months old. The deceasing trend of anemia based on age groups indicates the importance of iron supplementation in Iran, especially in developing countries.

Considering the population trend in Iran, an increase in the number of the elderly, and the significance of evaluating their health status, the present study was aimed to determinate the health status of the elderly in Nain, Iran.
Present research was a descriptive-analytic study (cross-sectional). The study population consisted of 220 elderly people from Nain who were randomly selected using randomized simple table from among households with elderly over 60. After the informed consent was obtained from the elderly, data were collected in face-to-face, in-person interviews. In order to determine their health status, The Short Form Health Survey-12 (SF-12) questionnaire was utilized.
The mean age of the subjects was 69.52±7.4 years. The linear regression test showed that there was linear relationship between the physical and mental health status after adjusting the demographic and socioeconomic variables, ANOVA showed no significant relationship between the health status and age, but there was a significant association between the income level and the health score (P The health status of the elderly was moderate in Nain. Since factors such as the education level, marital status, income level, and economic conditions affect elderly people’s health, it is necessary to take these into account and conduct appropriate interventions in this field.

Cutaneous fungal infections are common infections, which involve keratinized tissue (skin, hair, and nail). Dermatophytes are important and abundant cutaneous fungal agents. The aim of this study is to assess the epidemiology of dermatophytes and the prevalence of various type of tinea in Tehran province for better identification and treatment of patients.
Five hundred and eight patients suspected to have dermatophyte infections, after clinical examination, were referred to mycology laboratory of Razi Hospital in Tehran city for definite diagnosis, and then using direct examination and slide culture technique, and finally molecular examinations, the causative fungus of infection was diagnosed. Data were analyzed by chi-square statistical test at the significance level of (p£0.05).
Of 161 obtained positive samples, 73 (45.3%) patients were female and 88 cases (54.7%) were male. The mean age of patients was 42 years. The most and least common types of tinea were tinea pedis with 71 cases (44.1%) and tinea faciei with one case (0.6%), respectively. Trichophyton mentagrophytes was the the most isolated species and the least was Microsporum ferrugineum.
According to the results of this study, dermatophyte infections in different parts of the body, especially foot and groin, are considered as an important health problem in Tehran city. It seems that design and implementation of training programs with the purpose of primary and secondary prevention, especially for age group over 20 years, are necessary for reduction of cases of dermatophytosis.

Depression is one of the most important mental disorders affecting social, vocational and educational performance. The aim of this study was to determine the prevalence of depression and its related factors in Pishva District Health Network employees. In this cross sectional study, all 124 employees from Pishva District Health Network were enrolled. Depression among employees was assessed using a Standard Persian Depression Assessment Questionnaire (SAMA) and Religiosity was assessed using the Duke University Religion Index (DUREL). Univariate and multivariate logistic regression statistical analysis was performed through SPSS 21 Software. The prevalence of depression was 34.7% including 2.4% severe depression cases. There was a significant relationship between depression and female gender, religious beliefs and experiences, and employment duration. There was no statistically significant relationship between depression and other variables including age, number of children, marital status, educational level, employment status, having a second job, attending religious meetings and having personal religious activities. There was a high prevalence of depression in Pishva district health network employees. Therefore, it should be planned to promote mental health of the employees through detection of underlying causes, holding mental health workshops, educational meetings and consultation services.

Rabies is one of the fatal diseases in human and other mammals. With regard to lack of full control of the disease in wild and domesticated animals، There is stillt the possibility of incidence of the disease in our country. The aim of this study was to determine the epidemiology and causes of delays in getting treatment for rabies and animal bites in the city of Tabas during 2005-2010.

The present research is a descriptive cross-sectional study in which، the existing information for 480 bitten subjects referring to Tabas rabies units during 2005-2010 was used. Patient-related factors، factors related to location، factor related to the time of being bitten، the wound status as well as bite status were studied. The descriptive statistics، including descriptive indicator was used to analyze the data، and the logistic regression analysis was used to measure the effect of considered variables on delay in receiving preventive treatment of rabies. The analysis was performed using SPSS version 18.

Out of 480 bitten persons، 413 individuals (86%) were male and others 67 (14%) were female. Totally 54. 6% (262 cases) of animal-bite incidents were in the city and 45. 4% (218) had experienced it in the rural areas. The cases were mostly related to dog bites (63. 1%) and cat bites (27. 3%) respectively. Most bites had occured for 107 students (22. 3%) and 98 (20. 4%) for others. Mean and standard deviation of delay time in receiving the anti-rabies vaccines was 6. 5±1. 5 hours. The most offective factors in delaying or notdelaying were age (OR = 0. 98، CI: 0. 74-0. 99)، time of accident (OR = 1. 06، 1. 01-1. 12)، bite of the lower extremities (OR = 5. 31، CI: 3. 8-6. 33)، history of vaccination (OR = 0. 39، CI: 0. 21-0. 68)، having primary care recommended for the injury (OR = 6. 75، CI: 4. 4-8. 8) and animal type (OR = 4. 17، CI: 3. 34-6. 5).

Regarding the relatively high incidence of animal bites in this county، the necessity of controlling animals such as dogs and cats through training vulnerable individuals such as adolescents as well as animal owners and intersectional coordination to eliminate the straying animals should be more considered. Because of the imposed cost sustained by health system care for any bite، the preventive measure should be considered as priority.