دکتر رضا شکرریز فومنی

 After the global pandemic of coronavirus disease 2019 (COVID-19), many medical schools moved to online classrooms, resulting in lower social interactions and higher psychological issues among medical students, which can be associated with suicide ideation. This study aimed to predict suicide ideation based on perceived social support, personality traits, and meaning of life in medical students.

 This prospective, cross-sectional study was conducted on medical students of Shahid Beheshti University of Medical Sciences, Tehran, Iran, from 2021 to 2022. Based on the convenience sampling method, suicide ideation was assessed using the last Persian-translated valid questionnaires, including the Beck Scale for Suicidal Ideation (BSSI), the Multidimensional Scale of Perceived Social Support (MSPSS), the revised form of the NEO Personality Inventory (NEO-PI-R), and Meaning in Life Questionnaire (MLQ). The data were collected by filling out the checklist through a social media-based questionnaire and analyzed through the Pearson correlation coefficient and multivariate regression analysis by SPSS software.

 385 medical students [184 men with a mean ± standard deviation (SD) of age of: 27.9 ± 5.5] were included in the final analysis. The results showed a significant correlation between social support, personality traits, and meaning of life in medical students with suicide ideation (P < 0.01). Regression analyses also revealed a difference between social support, personality traits, and meaning in life (P < 0.05) which was more prominent in the neuroticism trait (β = 0.74).

 Perceived social support, personality traits, and meaning in life can predict the suicide ideation of medical students during the COVID-19 pandemic.

 In all surgical interventions including cesarean section, pain is a challenging issue.  The aim of this study was to identify the underlying causes that affect post-cesarean pain intensity.

 A total of 128 consecutive patients who underwent cesarean section at Taleghani hospital were included in the study. A questionnaire was used to gather the patients’ demographic and clinical data. The length of the incision was measured with a ruler on the first day following the cesarean section. In addition, the pain intensity was assessed using a Likert scale at scales: 1, 2, 4, 8, 12, and 24, on the day after surgery and 48 hours and one week later. Descriptive statistics were calculated for all variables. Analyses were conducted using SPSS version 22 and a p-value < 0.05 was considered statistically significant.

 The study showed that overall, patient age, BMI, level of education, type of surgical incision, duration of surgery, type of cesarean section, type of anesthesia, and breastfeeding were not predictors of postoperative pain intensity. However, the study found that “indication of the cesarean section” and the “stage of labor” in which the cesarean was performed are correlated with postoperative pain intensity. (P-value<0.05).

In this study, we were able to identify 2 parameters that were independently associated to postoperative pain scores: “underlying indication of cesarean section” and the “stage of labor” in which cesarean section is performed. This information helps clinicians to identify high-risk patients in terms of postoperative pain and take early action.

 COVID-19 is associated with dangerous thromboembolic complications, such as stroke, heart attack, pulmonary embolism, and arterial and venous thromboembolism (VTE). Early diagnosis and even prediction of thromboembolic complications using biomarkers could facilitate the treatment and decrease the mortality rate.

 This study evaluated and compared the clinical and laboratory findings of COVID-19 patients with thrombotic events with other COVID-19 patients.

 A total of 114 confirmed COVID-19 patients referred to Taleghani Hospital, Tehran, Iran, between February and September 2020 were included in this cross-sectional study. Those with a history of thromboembolic disease were excluded. The laboratory data, including the levels of lactate dehydrogenase (LDH), D-dimer, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and counts of lymphocyte and neutrophil, along with clinical findings (such as oxygen saturation and lung involvement percentage), were retrospectively collected from the patients’ clinical files. The incidence of thrombotic events was evaluated in patients.

 The prevalence of thrombosis in the right and left main pulmonary arteries, right and left sub-segmental pulmonary arteries, and right and left deep veins was 2.7%, 3.5%, 7%, 7.9%, 4.4%, and 1.8% of all patients, respectively. The results showed that thromboembolic complications were significantly associated with mortality (P < 0.001). Besides, it was found that LDH (P < 0.001) and neutrophil (P = 0.002) levels in thromboembolic COVID-19 patients were respectively higher and lower than those without thromboembolic manifestations.

 High LDH and neutropenia might serve as biomarkers for thromboembolism in COVID-19 patients.

Health promotion in occupational and educational environments contributes to the improvement and higher efficiency of the people affected by them. The health status of medical students as future providers of health services has great importance. This study aimed to evaluate health promotion standards in the school of medicineatShahid Beheshti University of Medical Sciences.

This cross-sectional study evaluated health promotion standards of school of medicineusing a questionnaire filled out by medical students in 2020. The validity and reliability of the questionnaire were confirmed. The questionnaire measured health promotion standards in the fields of healthy nutrition, facilities for proper physical activity, providing a healthy environment for students, adequate education for health promotion and disease prevention. Analytical and statistical tests were performed using IBM SPSS 23 software.

Among 340 medical students participatedin the study31.8 percent were in the basic sciences grade, 26.5 percent were stagers, and 41.8 percent were interns. The mean score of all questions among different grades was 1.11 (SD=0.33), 0.97 (SD=0.43), and 0.93 (SD=0.34), respectively (on a scale of 0-3). A significant difference was reported in the comparison of "basic sciences versus stagers (PV=0.011)" and "basic sciences versus interns (PV<0.01) ". the mean score of questions overall was 1.00 (SD=0.37).

Based on findings, health promotion in the schoolof medicine atShahid Beheshti University of Medical Sciences was in the medium range, which demonstrates the need for future policies that lead to a more efficient health-promoting environment.

Since the emergence in December 2019, the novel coronavirus disease 2019 (COVID-19) has caused a global pandemic that has infected so many people all around the world. As there are no vaccination or antiviral treatment available yet, public health measuresplay a substantial role in the management of this pandemic. Governments of affected countries have imposed different quarantine policies and travel bans. As quarantine can have many controversial aspects, this review intends to clarify its role in diseasecontrol and other aspects of human everyday life with due attention to a couple of epidemics in the past (SARS, MERS, and flu) and ongoing COVID-19 outbreak.

We conducted a thorough search in PubMed, Research Gate, Google Scholar, Excerpta Media Database (EMBASE), and Web of Science databases and collected all relevant articles to Quarantine in the past epidemics (SARS, MERS, and flu) as well as ongoing COVID-19 pandemic.

A total of 176articles were extracted in our primary search process. Primarily, 53 articles have been excluded because of duplication. The other 44 articles have been excluded due to different reasons (Lack of usefulinformationand eligibility of data). Finally, 79articles were selected for more evaluation(published untilApril 2020).

By having previous epidemics, including SARS, MERS, and flu, in mind, quarantine and isolation seem to be proper choices for this situation. But, as this epidemyis bigger than former ones, stricter public health measurements, such as serious social distancing and community-wide containment, are recommended.

There is evidence suggesting that the pregnancy outcome may be affected by some medical conditions, such as liver diseases.

The present study aimed to investigate the prevalence of liver disease and its outcomes in pregnant women referred to antenatal clinic in the hospital.

In this cross-sectional study, all pregnant women with abnormal liver function test attending antenatal clinic affiliated to Shahid Beheshti University of Medical Sciences were recruited from August 2017 to July 2018. All participants were followed-up until delivery with respect to the maternal and neonatal outcome.

Of a total of 7,121 pregnant women recruited in the study, 110 (1.58%) women were detected with a liver disease; of these, 105 women were diagnosed with pregnancy-specific liver diseases, including HELLP syndrome (10.9%), preeclampsia (50.98%), partial HELLP (0.9%), eclampsia (0.9%), acute fatty liver (9.1%), intra-hepatic cholestasis 25 (22.7%), and 5 women the non-pregnancy-specific liver disease, including Liver transplantation (2.7 %), and Autoimmune hepatitis (1.8 %). Prevalence of the premature birth was 64.5% in pregnancy-specific liver disease, but no premature birth was detected in cases with liver transplantation. We found that neonatal mortality was significantly associated with neonatal prematurity (p = 0.013), IUGR (p < 0.001), placental pathology (p = 0.04), we had no maternal mortality.

Liver disease is not uncommon in pregnancy. This study demonstrated that pregnancy is safe in women with liver disease.

The birth of a neonate with chromosomal abnormalities, e.g. Down syndrome has very serious problems for family, society, and for the neonate itself, and therefore prenatal evaluation is imperative in determining the fate of the fetus. This research aimed to assess the association and accuracy of amniocentesis with first-trimester combined screening. In this study, specimens from 1066 cases were analyzed for free Beta human chorionic gonadotropin, pregnancy-associated plasma protein A, along with nuchal translucency and nasal bone ultrasonography from October 2013 till November 2014. Upon observing positive screening, mothers underwent amniocentesis. Finally the amniocentesis results were compared with that of first-trimester screening. Our results determined a direct relation between the high age of the mother and gravidity with P of 0.001 and 0.020 with positive first-trimester screening. Our study attained a 92% accuracy rate of amniocentesis due to one case of mosaicism of trisomy 21, that was not diagnosed, because it was not requested by physician. Only 12 (17.1%) cases out of 70 (mothers with positive first-trimester screening) showed positive amniocentesis, which had a significant relationship with chromosomal abnormality. First trimester combined screening has very high accuracy (94.6%) in prediction of genetic abnormalities. The probability of positive first-trimester screening is directly influenced by number of factors, including the mother age and gravidity. Amniocentesis is necessary for all of mothers with positive first-trimester screening and will almost always detect chromosomal abnormalities.

Women’s activity in many social and religious events necessitates them to have their menstruation suppressed, including in yearly Hajj rites for Muslim women. According to the Islamic religious set-ups, Muslim women must be physically and morally clean during the Hajj rites in Mecca. In this research, the efficiency and side effects of extended consumption of hormonal agents in Iranian women during the Hajj rites in Mecca were examined.

The retrospective cross-sectional study involved a sum of 212 participants of pilgrim women recruited from 30 Sep. to 4 Nov. 2013, already prescribed with different types of hormonal agents for 35 - 36 days. Thereafter, they were assessed by questionnaires for the sake of success and side effects throughout the approach.

Out of 212 subjects, 161 (75.9%) had experienced menstrual delay during Hajj rites with no spotting. Women taking combined oral contraceptives within the first half of their menstrual cycle had a significant postponement of menstrual bleeding.

Majority of the pilgrim women who completed the Hajj rites thoroughly with no spotting were satisfied with the extended consumption of hormonal agents.