zohre foroozanfar

Diabetic foot ulcers (DFU) are common and serious, often leading to high mortality and recurrence rates. Despite conventional treatments, many patients turn to traditional medicine.

This study examines the use of complementary and alternative medicine (CAM) in the treatment of these ulcers.

This descriptive-analytical cross-sectional study was conducted on 300 DFU patients in Shiraz who visited the wound clinic in late 2021. Data were collected using a standard questionnaire, database management system (DBMS), and a file system. The questionnaire included information on traditional complementary/alternative measures, resources providing CAM, and the use of herbal medicines and nutritional supplements. Linear, ordinal, and logistic regression models were used for data analysis.

Among the participants (mean age 58.35; 62% male), 54% had moderate ulcers, and 83% had neuropathy. While only 46 (15.3%) participants followed lifestyle management principles, 254 (84.7%) used CAM, and 238 (79.3%) reported a history of using medicinal plants, with chamomile being the most frequently used (48.7%). Females were significantly less likely to use CAM compared to males (OR = 0.35; CI: 0.16 - 0.75). Similarly, residing in an urban area was associated with a significantly lower likelihood of CAM use compared to rural areas (OR = 0.13; CI: 0.06 - 0.31). A history of using phlebotomy (β = -1.42, P = 0.001), massage (β = -2.39, P = 0.003), acupuncture (β = -2.41, P = 0.002), spiritual treatments (β = -2.32, P = 0.026), green tea (β = -0.51, P = 0.026), and Urtica (β = -0.64, P = 0.025) were significantly associated with a lower grade on Wagner's classification. Additionally, the use of Sumac (OR = 0.39; CI: 0.23 - 0.68) and Eryngo tincture (OR = 0.51; CI: 0.28 - 0.93) were significantly associated with A1C < 7.

Complementary and alternative medicine use is widespread among diabetic patients in Iran. Education on CAM and professional guidance are essential, along with further research to understand the impact of CAM on diabetes management.

Depression, anxiety, and stress are prevalent among medical sciences students globally and contribute to suicidal ideation. Many risk factors are associated with the mental health problems of medical sciences students.

This study aimed to estimate the prevalence of depression, anxiety, stress, and suicidal ideation, as well as their associated factors, among medical, dental, and pharmacy students in the aftermath of the COVID-19 pandemic.

In this cross-sectional study, we included 292 students. We collected background information and data on socioeconomic status (SES). We used the Depression, Anxiety, and Stress Scales-21 (DASS-21) and the Beck Scale for suicidal ideation (BSSI) to assess depression, anxiety, stress, and suicidal ideation. The data were analyzed using a linear regression model.

The prevalence of medium to high-risk suicidal thoughts among all students was 56.8%, with 6.5% of students reporting high-risk suicidal thoughts. The prevalence of mild to extremely severe depression, anxiety, and stress was 66.8%, 59.5%, and 52.1%, respectively. Factors significantly associated with the severity of suicidal thoughts included being single (β = -2.11), having a positive history of psychiatric illness (β = 2.64), having a positive history of chronic medical conditions (β = 4.23), and higher scores of depression (β = 1.97) and anxiety (β = 0.49). Additionally, a higher academic semester and greater interest in courses were significantly associated with lower scores of depression, anxiety, and stress.

The findings of this study revealed a higher rate of depression, anxiety, stress, and suicidal ideation among medical sciences students compared to the global prevalence. This underscores the urgent need for targeted interventions to improve students’ mental health. More specifically, recognizing the risk factors for suicidality and promoting access to counseling services and mental health awareness programs can help prevent suicidal thoughts.

Depression and anxiety are common comorbidities complicating the care of breastcancer patients, but many patients do not receive the needed care. We aimed to assess utilization ofmental health care and its barriers in breast cancer survivors. This cross-sectional study was conducted on 311 patients with breast cancer, in Iran,November 2021 to March 2022. Perceived need and utilization of mental health care and barriers toservice utilization were measured based on self-report. Depression, Anxiety, and Stress Scale-21 andMultidimensional Scale of Perceived Social Support were used to assess depression, anxiety, and stressas well as social support, respectively. A linear and logistic regression model was used to analyze thedata using SPSS version 22. A P-value less than 0.05 was considered statistically significant. 70.1% of the participants perceived need for mental health care, 28.0% of them had used mentalhealth services, and 72% were classified as having unmet needs. The most common perceived barrierto service use was patients’ self-adequacy. The prevalence of extremely severe levels of depression,anxiety, and stress was 14.8%, 23.5%, and 10.6%. Also, 48.6%, 78.5%, and 75.6% of patients receiveda high level of social support from friends, family, and significant others. Findings highlight a substantial unmet need for mental health care and low utilization ofmental health services among breast cancer survivors. Given the significant prevalence of depression,anxiety, and stress in this population, it is imperative to address the underutilization of mental healthservices and to further examine the barriers preventing patients from seeking the care they require.

Many high-risk behaviors often co-occur during adolescents’ development and can be linked to their life patterns, beliefs, and early maladaptive schemas (EMS). This research aimed to determine the association between EMS and high-risk behaviors among teenagers in Shiraz, Iran.

This cross-sectional study was conducted in 2022, involving 348 adolescents aged 13 to 19 selected through a convenience sampling method in Shiraz, Iran. The Young Schema Questionnaire was utilized to assess EMS, and a researcherdeveloped self-reported checklist was used to collect demographic and behavioral data from the adolescents, including smoking, drug usage, alcohol use, and hookah use. Logistic regression assessed the association between behavioral characteristics and adolescents’ EMS aspects.

Among the 348 adolescents, 187 (53.7%) were male. The relative frequencies of hookah, alcohol, and drug use among boys were 31.6%, 40.1%, and 10.2%, respectively, whereas among girls, they were 11.2%, 15.5%, and 1.2%, respectively. A significant difference was observed between the two groups in terms of the relative frequencies of hookah (P=0.001), alcohol (P=0.001), and drug usage (P=0.008). A significant association was found between different domains of schemas and high-risk behaviors among the participants.

The findings suggested that EMS may predict high-risk behaviors. Therefore, early-life interventions should be considered in line with factors contributing to controlling the negative consequences of EMS among adolescents. Further research is recommended to evaluate this population’s predisposing factors for EMS and preventive interventions.

Physical fitness and optimum functional movement are essential for efficient performance of job tasks without fatigue and injury. This study aimed to investigate the relationship between Functional Movement Screening (FMS) test score and prevalence of Musculoskeletal symptoms (MSSs) in emergency nurses and Emergency Medical Services (EMS) staff. The present study also sought to determine optimum cut-off point of FMS test score in health personnel. This cross-sectional study was conducted on 134 male and female emergency nurses and EMS technicians. After watching a video tutorial and undergoing practical training of how to do the FMS test, the participants carried out the test while wearing comfortable clothes. In addition to the demographic data questionnaire, Nordic musculoskeletal questionnaire was also completed for each participant. The data were analyzed using the SPSS software, version 18 at the significance level of 0.05. Totally, 49.3% (n=66) of the participants were female. The subjects’ mean age and work experience were 35.3±8.7 and 11.4±7.7 years, respectively. Cut-off point of 17 was determined with the highest sensitivity (0.71) and specificity (0.71) based on ROC curve. The highest prevalence of MSSs was observed in the knees (n=44, 32.8%) and lower back (n=31, 23.1%). Multiple linear regression modeling also showed that age, sex, and the prevalence of MSSs were significantly associated with the FMS test score. FMS test seems to be an appropriate screening tool in pre-employment and periodic medical tests for jobs requiring physical fitness and optimum functional movements.

Chronic patients need regular follow-ups. During the COVID-19 pandemic, these regular visits can be affected. The delay of chronic patients and its contributing factors in their periodic visits during the COVID-19 pandemic are examined here. This cross-sectional study was conducted between February and June 2021, in Fars, Iran. Two hundred and eighty-six households with at least one chronic patient were recruited. Then, several trained questioners called the studied households and asked about the studied variables. The dependent variable was the number of delays in regular visits during the COVID-19 pandemic. The results were analyzed through Poisson regression by SPSS Statistics version 22 and GraphPad Prism software version 9. A significance level of 0.05 was considered for this study. Out of 286 households 113 (73.4%) fathers, 138 (70.1%) mothers, and 17 (58.6%) children in the households reported delayed referral. In fathers, referring to the health center was significantly associated with a decrease in the number of delays (P=0.033). The higher age of the householder (P=0.005), the higher number of children (P=0.043), and having a family physician (P=0.007) in the mothers' group, also the number of children in households P=0.001 in the children group were significantly associated with increasing the number of delays. COVID-19 pandemic not only creates direct harmful effects but also adversely affects people in danger of chronic diseases. Delays in follow-ups are taken into account as a major challenge during the COVID-19 pandemic. This issue is not limited to rural or urban residency.

 Coronavirus disease 2019 (COVID-19) has turned into a global public health crisis since the end of 2019. It may thus take years to develop new drugs, so evaluating the existing ones can play a key role in suppressing or even mitigating the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.

 This study reflected on the effects of ivermectin (IVM) and metronidazole (MTR) vs. standard treatment protocols on symptoms, humoral immune responses, and outcomes of COVID-19 in hospitalized patients.

 This triple-blinded randomized controlled trial (RCT) of IVM and MTR vs. standard treatment protocols was conducted from February 2021 to May 2021. A total number of 107 participants were accordingly selected from all patients infected with SARS-CoV-2 and positive results for SARS-CoV-2 based on the reverse transcription-polymerase chain reaction (RT-PCR) or the computerized tomography (CT) scan results at three teaching hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. In this RCT, several indicators, including some vital signs, biomedical parameter, length of hospital stay (LOS), and death, were considered the outcomes.

 A total number of 107 patients were recruited in this study. The results revealed that 10 patients (10.4%) expired during hospitalization. The mortality rate in IVM group (4.5%) was lower compared with MTZ (15.8%) and standard treatment (11.8%) (P = 169). After five days, the mean differences of lymphocyte and neutrophil counts differed significantly between groups (P = 0.020 and P = 0.029, respectively). But, other outcomes did not differ (P > 0.05).

 Based on this RCT, neither IVM nor MTZ could significantly affect COVID-19 patients’ recovery patterns compared with the standard treatment protocols. Hence, more studies are needed to test diverse combinations of immunological response triggering and anti-inflammatory drugs. Moreover, including and relying on IVM in clinical guidelines for COVID-19 should be cautioned and based on more evidence.

This study aimed to evaluate the quality of services provided in Voluntary Counseling and Testing (VCT) centers from the perspective of clients.

This cross-sectional study was conducted on people living with human immunodeficiency virus (PLWH) in Shiraz, Iran, in 2019. The data were collected using a SERVQUAL questionnaire.

The mean scores of expected and perceived service qualities were 4.81 (95% CI: 4.741 - 4.864) and 3.96 (95% CI: 3.901 - 4.019) in male subjects and 4.85 (95% CI: 4.80 - 4.89) and 4.09 (95% CI: 4.01 - 4.135) in female subjects, respectively. There was a significant difference between the expectations and perceptions of clients in all dimensions of service quality in VCT centers. The gaps in the dimensions of responsiveness and empathy were greater than all other dimensions.

Due to the high dissatisfaction of PLWH with the quality of services in the responsiveness, accessibility, and empathy dimensions, priority should be given to these dimensions in any improvement effort. The low education level of this group should be taken into account for any educational programs to be successful.

Adolescence is one of the most important and challenging stages in life. psychological, cognitive and emotional changes during this period can expose adolescents to high risk behaviors.

The current study examined the effectiveness of resilience training on emotional intelligence (EI) and assessed gender differences in this regard among adolescents living in the outskirts of Shiraz, Iran.

This pre-post study included 191 students and used an intervention consisting of nine resilience-training sessions. The evaluated outcomes were EI and its 15 components. The paired-samples and independent-samples t-tests were used to analyze the data.

Out of 191 students, 88 (46.1%) were boys. Before and after the intervention, the mean EI score for boys was 312.52 ± 37.79 and 327.31 ± 37.75, while for girls, it was 310.74 ± 30.05 and 312.20 ± 29.51, respectively. Following the intervention, the scores of boys in problem-solving (P = 0.007), happiness (P = 0.001), emotional self-awareness (P = 0.044), optimism (P = 0.029), self-regard (P = 0.046), impulse control (P = 0.013), and social responsibility (P = 0.042), as well as the total score of EI (P = 0.005), increased significantly. However, only the optimism score (P = 0.004) rose significantly in girls post-intervention. In addition, there were significant differences in the mean of problem-solving (P = 0.006), happiness (P = 0.001), impulse control (P = 0.042), and the total score (P = 0.035) between boys and girls, before and after the intervention.

Resilience training may help moderate high-risk behaviors among adolescents living on the outskirts of Iran’s major cities, particularly boys. Based on the gender differences in EI components, it was suggested that female adolescents required significantly more attention. Nonetheless, gender differences in EI components were contentious, and it was concluded that a variety of factors, including the socio-cultural context, may be involved.

Several studies have reported that many people living with HIV (PLHIV) complain of memory impairments.

This study aimed to investigate these complaints both subjectively and objectively. Patients and

For this purpose, 50 PLHIV and 50 of their companions as the control group were selected by the convenience sampling method in Shiraz, Iran, and completed Ray's auditory-verbal learning test and the Patient’s Assessment of Own Functioning Inventory (PAOFI). Data were analyzed using a t-test in SPSS.

Our findings showed a significant difference between PLHIV and the control group in terms of subjective memory complaints and objective memory functions.

The overall result of the study showed that PLHIV reported more subjective memory complaints and poorer objective memory functions than the control group, regardless of the stage of the disease.

Health promotion of adolescents requires appropriate evidences of its determinants. The aim of this study was to investigate predictors of self-rated health (SRH) among adolescents in Qazvin, Iran.

In this descriptive cross-sectional study, with a multistage sampling method, we recruited 1740 adolescents aged 12–19 years from 53 schools in Qazvin, Iran (2018). We used the Strengths and Difficulties Questionnaire and Adolescents’ Academic Stress Questionnaire for data collection. The analysis was conducted using a multilevel logistic regression model. Gender, educational period, and socioeconomic status were considered as confounders.

Almost 21% of the adolescents reported their SRH suboptimal. Suboptimal SRH was higher in girls and older adolescents. Mental health disorders and academic stress had a positive association with SRH. However, this association was negative for academic achievement and physical activity. The interaction between mental health disorders and academic stress with SRH had a significant association in a crud regression model.

Mental health, academic stress, academic achievement, and physical activity were important predictors for SRH. Interventions that focus on promoting mental health, academic stress, academic achievement, and physical activity such as physical activity for 1 h and each day for 3 days per week can improve SRH in adolescents. Hence, policymakers should pay more attention to this issue in health promotion programs of adolescents

Metabolic syndrome is highly prevalent in type 2 diabetics and is a strong risk factor for cardiovascular diseases in such patients. The aim of this study was to determine the prevalence of metabolic syndrome according to the three criteria of ATPIII, IDF and the new criteria for metabolic syndrome diagnosis in Kerman, Iran.This cross-sectional study was performed on 950 diabetic type 2 patients. Data was analyzed by independent t-test, chi-square and logistic regression using the SPSS (revision 20) software.The prevalence of metabolic syndrome in Kerman was 73.4, 64.9, and 70.4%, according to the above criteria. Fasting blood sugar, gender, triglyceride, HDL, waist circumference, and systolic blood pressure were related to the prevalence of metabolic syndrome according to the above-mentioned criteria.

An important issue the world faces today is ensuring that households living in different countries have access to enough food to maintain a healthy life. Food insecurity is prevalent in both developed and developing countries. The objective of this study was to assess the household food security status and related factors among different rural districts of Neyshabur (A city in northeast of Iran). Of 5000 selected rural households 4647 were studied in this cross-sectional study. A validated short questionnaire (with six questions) was used to measure food security. Chi-square test and logistic regression were used for data analysis through SPSS software. In total, 2747 households (59.1%) were identified as food secure. The highest prevalence of food security was observed in Central district (62.3%) and the lowest was in Miyanjolgeh district (52.9%). Backward multiple logistic regression revealed that car ownership, presence of chronic disease in household and household income (per month) were significantly associated with food security in all of surveyed districts (p< 0.05). According to results of this study, lower than 60% of Neyshabur rural households were food secure and economic variables were the most important factors. Therefore, a special attention should be paid to this health problem in these regions.

Recognition of views and expectations of students is an important issue to improve the quality of educational services in the universities.. The aim of this study was to evaluatethe quality gap of educational services by using Service Quality (SERVQUAL) instrument in Neyshabur Faculty of Medical Sciences in viewpoints of students.. In this cross-sectional study, data were collected usingSERVQUAL instrument which comprisedof two questionnaires (perception and expectation) and each of them comprised 27 items based on the Likert scale. This questionnaire evaluatedfive dimensions of service: assurance, responsiveness, empathy, reliability and tangible Questionnaires were distributed between 199 students study atNeyshabur Faculty of Medical Sciences and 198 were returned (response rate = 99.5%); one questionnaire was excluded because it was notreturned. Quality gap of educational services was determined based on differences between students'' perceptions and expectations. Data were analyzed using SPSS16 software.. The mean age of the students was 20.38±1.92 years; 65.7 % were female and 34.3% were male. There was a negative quality gap in each of the five SERVQUAL dimensions. The overall mean of quality gap was -1.31. The greatest and the least negative quality gap means were observed in the tangible (-1.62) and reliability (-1.02) dimensions, respectively. There were significant differences between perceptions and expectations of students in all dimensions represented by SERVQUAL (P < 0.05).. The results of this study showed that there is a notable gap between students'' expectations and what they have actually received of educational services. Thus, improvements are required in all dimensions of educational services quality..

Cesarean delivery is a surgery for deliver a baby. Women with previous cesarean delivery (CD) must often choose between a vaginal delivery (VD) and repeat CD. Our aim of this study was to investigate factors associated with preference for CD in Neyshabur pregnant women with previous CD. A cross‑sectional study was conducted on all pregnant women (who had previous caesarean delivery) from February 20, 2011 to March 20, 2011 in Northeast of Iran (Neyshabur). Logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). The mean age of pregnant women was 29.95 ± 4.94 years. In this study of the 292 pregnant women, 235 (80.5%) said they prefer CD. There was a statistically significant relation between preference for CD and the following variables: pregnant women’s educational level (P < 0.001; OR = 3.86; 95% CI = 1.85-8.05) and doctor’s advice (P = 0.021; OR = 3.55; 95% CI = 1.21-10.43). The pregnant women with a previous CD presented four‑fold upper chance of choosing CD. As observed in this study, most pregnant women with previous caesarean delivery prefer repeated caesarean delivery rather than VD in their subsequent pregnancy and educational level of pregnant women and doctor’s advice were important factors that influenced this preference. This subject suggests the need to counsel pregnant women with an obstetrician before select delivery type.