predictor

Neonatal bilious vomiting is a more clinical symptom that can be difficult to diagnose and assess immediately due to its relationship with actual life-threatening illnesses, like neonatal intestinal obstruction. The study examines the relationship between neonatal diagnosis, particular X-ray or contrast imaging results, conclusive vomiting diagnosis, gestational age, weight, age of presentation, or gender.
This is a cross-sectional study of 42 patients collected from Al Zahraa Teaching Hospital in Al-Najaf from January 2022 to January 2023. The data for all neonates collected are Gestational age (weeks), Weight (kg), Age of presentation (months), Gender, X-ray diagnosis (Diagnostic, invert gram, Negative, Nonspecific, Suggestive), Contrast diagnosis (Diagnostic, no need, Normal and Suggestive), and finally, definitive diagnosis.
There was a significant association between the diagnosis and specific X-ray or contrast imaging results, but there was a lack of significant association between definitive diagnosis and gestational age, weight, age of presentation, or gender. However, there was a significant association in diagnosing conditions like small bowel atresia, anorectal atresia, sepsis, and Meconium ileus based on imaging characteristics.
Neonates with bilious vomiting disclose an essential association between imaging outcomes and diagnoses as small bowel atresia and anorectal malformations, with X-ray and contrast imaging having an essential role in diagnosis.

COVID-19 was triggered by the severe acute respiratory syndrome coronavirus-2, leading to a pandemic. The risk of developing dysphonia and dysphagia amongst COVID-19 patients is considered to be high.

In this prospective study, 150 patients affected by COVID-19 admitted to the intensive care unit (ICU) and the ward of Firoozgar Hospital in Tehran, Iran, were analyzed. Dysphagia and dysphonia were evaluated according to the swallowing impairment score and the consensus auditory-perceptual evaluation of voice (CAPE-V). Also, the quality of life (QoL) was measured using the Persian version of the voice handicap index, the swallowing QoL and the Persian version of the dysphagia handicap index (DHI).

A total of 150 COVID-19 patients (mean age: 59.64±17.87 years and 54.3% male; 75 admitted patients to the ICU and 75 patients admitted to the ward) were evaluated. A total of 115(77%) patients with COVID-19 were experiencing dysphagia, and the prevalence of dysphagia did not vary meaningfully between the two sets. According to the swallowing QoL, the QoL of the two groups was meaningly different (P<0.05). Also, the QoL of patients admitted to the ICU was lower than those admitted to the ward. A total of 91(61%) COVID-19 patients had dysphonia and dysphonia prevalence was significantly varied among the two groups (P<0.05). Investigating the relationship between dysphagia severity, dysphonia severity, and age showed a significantly positive correlation (P<0.01). However, the length of stay had a positive correlation only with the severity of dysphonia (P<0.05). Also, a negative correlation was found between swallowing QoL, dysphagia severity, and dysphonia severity (P<0.01).

Dysphagia and dysphonia were prevalent among COVID-19 patients and more common in older patients. Early evaluation is required for timely and efficient intervention to avoid further complications and to progress their QoL.

This study aimed to assess the predictors of Metabolic Syndrome (MetS) among administrative employees of Rafsanjan University of Medical Sciences in Rafsanjan, Iran. A cross-sectional (descriptive-analytical) study was conducted from July to September 2022, involving 171 employees from the administrative departments of Rafsanjan University of Medical Sciences. Participants did not possess academic qualifications in biomedical fields but met other inclusion criteria. Data were collected on demographic information, Body Mass Index (BMI), waist circumference, blood pressure (BP), fasting blood sugar (FBS), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). The mean age of the 171 employees (88 men, 51.46%) was 42.7 ± 8.2 years, with ages ranging from 25 to 64 years. MetS was identified in 12.9% (n=22) of the employees. Participants with MetS exhibited significantly higher mean values for age (p=0.005), FBS (p<0.001), TG (p<0.001), systolic BP (p=0.007), diastolic BP (p=0.002), waist circumference (p<0.001), and BMI (p<0.001) compared to those without MetS. However, no significant differences were found in serum levels of LDL-C (p=0.742), HDL-C (p=0.333), and TC (p=0.415) between the two groups. The binary logistic regression analysis revealed that four variables—BMI, waist circumference, FBS, and age—were significant predictors for MetS among the study participants. Given the significant predictors of MetS identified in this study, it is crucial to develop and implement interventions that promote a healthy lifestyle among administrative employees at Rafsanjan University of Medical Sciences. Prioritizing strategies to reduce waist circumference and BMI, as well as controlling FBS levels, is recommended for this population.

 Consecutive miscarriages are considered recurrent pregnancy loss (RPL), which affects 1-2% of women and may be unpleasant for couples attempting to conceive. Patients and healthcare professionals confront a difficult situation in this regard. The present study was conducted with aim to investigate the potential role of anti-mullerian hormone (AMH) in predicting the rate of live birth in women with RPL who are trying to conceive naturally.

 This cross-sectional study involved 60 pregnant women from Baghdad and Al-Najaf infertility centers (June 2022 - June 2023), recording age, gestational age, miscarriage frequency, fetal outcomes, parity, and number of live births. AMH levels were measured using Minividas Biomeriux 2020 (France), followed by assessments of FSH and Estradiol. Low AMH prompted further tests for autoimmune and genetic disorders. Inclusion criteria were all pregnant women with spontaneous or induced pregnancies and a history of recurrent miscarriage. Exclusions were those with unexplained pregnancy loss and male factor infertility.

 The mean age of participants was 32.8 years, with 46.7% aged 21-30 years. AMH levels were higher in females aged 21-30 years, those with two abortions, and those with two parities. A significant correlation was observed between age over 40 years and a history of four abortions.

 AMH emerges as a crucial biomarker that intertwines with various aspects of female reproductive health, including miscarriage history, age, and parity. Future research is needed to deeply investigate the mechanisms behind these associations and offer more comprehensive insights into female fertility dynamics.

The rising popularity of reverse total shoulder arthroplasties (RTSA) demands attention to its growing costs on the healthcare system, especially with the implementation of bundled payments. Charges associated with patients’ inpatient stays can be mitigated with a better understanding of the drivers of cost following RTSA. In this study, we evaluate potential pre -operative and post-operative factors associated with higher inpatient costs following RTSA. We identified 59,925 patients who underwent RTSA using the National Inpatient Sample between 2016 and 2019. Total inpatient hospital charges were collected, and patients were divided into “normal cost” or “high cost”groups. The high cost group was defined as patients with total costs greater than the 75th percentile. Univariate and multivariate analyses were performed on pre-operative demographic and comorbidity variables as well as postoperative surgical and medical complications to predict factors associated with higher costs. T-tests and Chi-squared tests were performed, and odds ratios were calculated. The mean total charges were $141.213.93 in the high cost group and $59,181.94 in the normal cost group. Following multivariate analysis, non-white patients were associated with higher costs by 1.31-fold (P<0.001), but sex and age were not. Cirrhosis and non-elective admission had higher odds of higher costs by 1.56-fold (P<0.001) and 3.13-fold (P<0.001), respectively. Among surgical complications, there were higher odds of high costs for periprosthetic infection by 2.43-fold (P<0.001), periprosthetic mechanical complication by 1.28-fold (P<0.001), and periprosthetic fracture by 1.56-fold (P<0.001). Medical complications generally had higher odds of high costs than surgical complications, with deep vein thrombosis having nearly five times (P<0.001) and myocardial infarction almost four times (P<0.001) higher odds of high inpatient costs. Post-operative medical complications were the most predictive factors of higher cost following RTSA. Pre-operative optimization to prevent infection and medical complications is imperative to mitigate the economic burden of RTSA’s. Level of evidence: III

Since December 2019, COVID-19 spread worldwide. Patients with COVID-19 are at high hazard for dysphagia. This study investigates the incidence of dysphagia in COVID-19 patients admitted to the intensive care unit (ICU) and identifies predictors of dysphagia in COVID-19 patients.

This prospective study analyzed 100 COVID-19 patients admitted to the ICU of Firoozgar Hospital in Tehran City, Iran. The demographic and clinical features of the eligible patients were collected. Dysphagia and cognition were evaluated according to the Persian version of functional oral intake (FOIS-P) status and the Rancho Los Amigos scale (RLAS). The qualitative variables are described in frequency and percentages and the quantitative variables are illustrated by Mean±SD. Also, univariate and multivariate cox regression was performed to predict possible relations between demographic and clinical variables with dysphagia.

A total of 100 COVID-19 patients (43.3±13.3 years, 55% were men) who were admitted to the ICUs were appraised by speech and language pathologists. Meanwhile, 70% of the subjects had at least one comorbidity, with the most common ones being diabetes, hypertension, and obesity. Also, 74% of patients were on invasive mechanical ventilation (60% through endotracheal tube and 40% through tracheostomy). In addition, 57% of patients presented dysphagia. Age (odd ratio (OR)=1.127; 95% confidence interval (CI), 1.019%, 1.247%; P=0.02) and level of consciousness (OR=0.393; 95% CI, 0.178%, 0.868%; P=0.021) were predictors of dysphagia. 

Dysphagia was prevalent among COVID-19 patients predicted by age and level of consciousness. Early evaluation of suspected patients is required for timely and efficient interventions to avoid further problematic issues and progress their quality of life.

This study aimed to determine the rate of readmission for trauma patients in ICUs, as well as thefactors that predict this outcome. This retrospective cohort study was conducted at Emtiaz Hospital, a level I referral trauma center(Shiraz, Iran). It analyzed the ICU readmission rates among trauma patients over three years. The requireddata were extracted from the Iranian Intensive Care Registry (IICUR), which included patient demographics,injury severity, physiological parameters, and clinical outcomes. Statistical analysis was performed using SPSSversion 25.0. Descriptive statistics and different statistical tests, such as T-tests, Mann-Whitney tests, Chisquare tests, and logistic binary regression test were utilized. Among the 5273 patients discharged from the ICU during the study period, 195 (3.7%) were readmittedduring the same hospitalization. Patients readmitted to the ICU had a significantly higher mean age (54.83±22.73years) than those who were not readmitted (47.08 years, p<0.001). Lower Glasgow Coma Scale (GCS) scoresat admission and discharge were associated with ICU readmission, implying that neurological status andreadmission risk were correlated with each other. Furthermore, respiratory challenges were identified as theleading cause of unexpected readmission, including respiratory failure, hypoxic respiratory failure, respiratorydistress, and respiratory infections such as pneumonia. Injury patterns analysis revealed a higher frequency ofpoly-trauma and head and neck injuries among patients readmitted to the ICU. This study underscored the importance of ICU readmission among trauma patients, with a highreadmission rate during the same hospitalization. By developing comprehensive guidelines and optimizingdischarge processes, healthcare providers could potentially mitigate ICU readmissions and associatedcomplications, ultimately enhancing patient outcomes and resource utilization in trauma ICU settings. Thisresearch provided valuable insights to inform evidence-based practices and improve the quality of care deliveryfor trauma patients in intensive care settings.

This study aimed to identify the clinical features and predictors of mortality in patients hospitalized with Coronavirus disease 2019 (COVID-19) in southern Iran. This cross-sectional study was performed on patients with COVID-19 admitted to Ali Asghar Hospital in Shiraz, Iran, in 2021. All patients with a definitive diagnosis of COVID-19 were included in the study. The required information was extracted from the patient's medical records. In this study, 619 patients with COVID-19 were included. Sixty-four patients (10.3%) died due to COVID-19, and 555 (89.7%) patients recovered. The clinical signs of breath shortness, muscle pain, low Oxygen saturation, and intubation were statistically significant between the two groups (P<0.05). The results of the multivariate logistic model showed that age >52 years, diabetes, and SaO2 level less than 90% significantly increased the risk of death in COVID-19 hospitalized patients. The results of the study showed that patients with SaO2 levels less than 90% and over the age of 52 and those with diabetes had a higher risk of mortality from COVID-19. Therefore, identifying COVID-19 risk factors and deaths will have important implications for clinical management and disease reduction strategies.

 Epithelial ovarian cancer is one of the leading causes of death from gynecological cancers in the Western world. One of the important objectives of medical research is to determine predictors of an event. Regarding the interaction of risk factors, regression methods are unsuitable when the number of factors is high.

 Regarding frequency predictors of recurrence-free survival in epithelial ovarian cancer, our aim in this article is to determine predictors and time to first recurrence using a classification and regression tree model.

 This retrospective analysis used medical and chemotherapy records of 141 patients with epithelial ovarian cancer between 2007 and 2018. They were referred to Imam Hossein Hospital in Tehran. Data were analyzed using classification and regression trees in Rver3.4.3.

 The regression tree results showed that the worst recurrence-free survival in metastatic patients was in grade II patients (15.03 ± 11 months), but in patients without metastases were in patients with CA125 tumor marker above 207 that used 3-week chemotherapy courses (14.53 ± 6.4 months). The classification tree also showed that the most probability of the first recurrence in metastatic patients was in patients with adjuvant chemotherapy (0.81), and patients without metastases were among those with stages 2, 3, and 4 with the maximum platelet count above 305,000 and less than 35 years old (0.75).

 The classification and regression tree models, without any assumptions, can estimate the probability of recurrence in different subgroups. These models can be used in deciding due to the ease of interpretation by physicians and paramedics.

For successful aging, it is necessary to evaluate social health as a basic component of the health system. Older adults are an increasingly large proportion who are potential candidates for vulnerability in social health.

This study aimed to determine social health and its related factors in older adults referred to urban comprehensive health service centers.

This cross-sectional study was conducted on 400 older adults referred to urban comprehensive health service centers in Ardabil City, Iran, between February 2021 and April 2022. The multistage sampling method was used to select the older adults. The social health scale for older people was used for data collection. Data were analyzed using an independent t-test, one-way analysis of variance, the Tukey post hoc test, the Pearson correlation coefficient, and linear regression with a stepwise method.

The Mean±SD age of the participants was 69.49±7.16 years. The mean score of social health was 57.27±8.7, and for subscales of social support, social adjustment, and perceived environment resource were 30.16±5.9, 15.15±4.14, and 11.95±2.83, respectively. Multivariate analysis showed that marital status (B=4.68, 95% CI, 2.82%-6.54%, P=0.001), education (B=-2.89, 95% CI, -4.87% to -0.9%, P=0.004), job (B=-2.15, 95% CI, -4.1% to -0.21%, P=0.03), income (B=1.48, 95% CI, 0.63%-2.89%, P=0.04), visiting exhibitions (B=4.69, 95% CI, 2.39%-6.98%, P=0.001), and recreational or fun activities (B=-2.36, 95% CI, -3.99% to -0.72%, P=0.005) were predictors of social health in older adults (R2=20%).

The social health of older adults is moderate. Our study showed that several factors would influence social health. Healthcare providers should plan necessary interventions to enhance the social health of older adults.

Patients with multiple sclerosis (MS) are considered at higher risk of COVID‑19 infection due to treatment with immune modulators and immune‑suppressive agents. The exact risk factors are not clear. So, we aimed to conduct a study to determine the predictors of catching COVID‑19 infection during the pandemic stage in patients with multiple sclerosis (MS).

We conducted a multicenter screening study and developed an online questionnaire to collect patients’ self‑reported demographic features along with MS‑related and COVID‑19–related information. The online questionnaire link was released by the Iran Multiple Sclerosis Society (IMSS) social media channel, accessible for 4160 MS patients totally and also was sent by WhatsApp for nonmember cases.

Totally, 1448 MS patients participated in our study. Twenty‑five (1.7%) patients were diagnosed with COVID‑19, from which 4 were hospitalized, 4 were treated with medical therapy, and 17 patients had home‑quarantine. The patients with COVID‑19 diagnosis were more frequently treated with rituximab (28% vs 24%, P = 0.001) than others, and cardiovascular comorbidity was more frequent in this group (8% vs 1.6%, P = 0.01). Regression analysis showed that cardiovascular disease was a significant positive predictor of COVID‑19 infection (OR = 5.2, 95% CI: 1.1–23.7).

Patients with MS who have cardiovascular disease should be more monitored for COVID‑19 infection as they are at higher risk of infection.

It is necessary to study the predictors of life quality in the early postpartum period. Early diagnosis, timely care and intervention can improve the health of mother and baby. We aimed to evaluate the predictors of the quality of life in the postpartum period.

This cross-sectional study was conducted on 407 eligible women aged 18 to 47 yr, in the postpartum period, selected from clinics affiliated with Shahid Beheshti University of Medical Sciences, Tehran, Tehran, Iran in 2018. Data were collected using a demographic and obstetric questionnaire and Maternal Postpartum Quality of Life (MAPP-QOL) with Cronbach's alpha coefficients of 0.96 to assess personal details and postpartum quality of life. Data analyzed using SPSS. Linear regression analysis was performed to examine the relationship between maternal predictors and quality of life in the postpartum period.

The postpartum quality of life had a significant relationship with income status (P<0.001), Number of Children (P=0.031), mother's education(P=0.009) and maternal complications (P<0.001).

This study confirmed the relationship between maternal predictors and the postpartum quality of life. It could facilitate clinicians and educators to improve the quality of life for postpartum women.

Physical activity and nutrition can affect some serum markers associated with metabolic syndrome (MetS). We aimed to ascertain the prevalence and predictors of MetS among middle-aged women in this study.

This cross-sectional descriptive-analytical study was performed on 164 eligible middle-aged women. Sampling was performed by two-stage cluster random sampling among all the health care centers in Kamyaran, Iran. Data were collected through anthropometrics, Food Records, and International Physical Activity Questionnaires. Serum lipid profile and glycemic control indexes, calcium, and 25-hydroxy vitamin D3 were assayed. Blood pressure was measured. The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria were used to detection of MetS.

Forty-one women (25.0%; 95% CI: 18.4% to 31.6%) had MetS. Fasting blood sugar (FBS) (adjusted odds ratio (aOR): 0.020; 95% CI: 1.001 to 1.039), triglyceride (aOR: 1.024; 95% CI: 1.015-1.033), low physical activity: walking (aOR: 0.999; 95% CI: 0.998 0.999), dietary iron (aOR: 1.059; 95% CI: 0.989- 1.134) and waist circumference (aOR: 1.062: 95% CI; 1.020 1.105) have been detected as the MetS predictors in this study.

Higher serum levels of FBS and triglyceride, higher iron intake and waist circumference, and low physical activity enhanced the chance of getting MetS.

This study aimed to assess the predictive factors of marital satisfaction among married people in Kermanshah and Hamadan cities, Iran.

The present mixed study (sequential exploratory plan) was carried out in two stages. In the first stage (qualitative), using purposive sampling method, 67 married men and women who had successful marriage interviewed. The content analysis method was used to analyze the interview data, and 20 factors were identified. Then, in the second stage (quantitative), a 116-items researcher-made questionnaire prepared to measure the possible effect of these 20 factors. Then, 372 married people were selected using multi-stage sampling method from Hamadan (200 case) and Kermanshah (172 case). The participants fulfilled the Enrich's Marital Satisfaction Questionnaire and Researcher-Made Questionnaire of Marital Satisfaction Factors. Data were analyzed by using analysis of variance and step-wise regression.

The variables of expressing of feelings, trust, realism/acceptance, and respect were the most important predictors of marital satisfaction among married people of Hamadan city these variables explained 60% of the variance of marital satisfaction. While, the most important predictors in couples of Kermanshah were expressing of feelings, trust, and respect. They explained 31% of variance. Moreover, expressing of feelings, trust, respect, consultation, appreciation and expressing satisfaction with life respectively were the most important predictors of marital satisfaction among all couples and explained 51% of the variance of marital satisfaction.

Based on the findings, expressing of feelings, trust, respect, consultation, appreciation and expressing satisfaction with life can predict marital satisfaction.

Breath holding spell (BHS) is a sudden, reflexive, non-epileptic phenomenon that is common in infancy and early childhood. The aim of this study was to determine the predictors of breath holding spell (BHS) in children under 5 in Iran.
The study was a case-control study (case, n=55; control, n=55). The cases were selected from children with BHS who had been referred to Mohammad Kermanshahi Hospital of Kermanshah, during 2019. Then, for each case, one control was selected among the children who referred to other wards of this hospital for reasons other than BHS.The data collection tool was a data collection form including demographic, family, obstetric and biochemical characteristics. The biochemical parameters (such as serum calcium, magnesium, albumin, phosphorus and vitamin D levels) were measured by a fully automatic auto-analyzer (Prestige 24i Tokyo-Boeki, Japan). Univariate and multivariate logistic regression models were used to data analysis by STATA 14.
The mean age of children for case and control groups were 22.85 ± 15.34 and 23.29 ± 16.91 months, respectively. The numbers of boys were 32(58.20) and 29(52.70) for case and control groups; respectively. The multivariate logistic regression model showed that the calcium (OR=9.03; 95% CI: 2.51 – 32.48), household size (OR=0.19; 95% CI: 0.04 – 0.90), paternal education (OR=0.48; 95% CI: 0.24 – 0.97), and history of mental illness in family (OR=8.97; 95% CI: 1.15 – 69.72) were, statistically, the most important predictors of BHS in children under 5 years.
Calcium, household size, paternal education and history of mental illness in family were the most important predictors of BHS in children under 5 years; however, studies with larger sample size are required.

This study was conducted to investigate prevalence and predictors of slow coronary flow phenomenon (SCF) phenomenon.

This cross-sectional study was performed at Imam Ali Cardiovascular Hospital affiliated with the Kermanshah University of Medical Sciences (KUMS), Kermanshah province, Iran. From March 2017 to March 2019, all the patients who underwent coronary angiography were enrolled in this study. Data were obtained using a checklist developed based on the study’s aims. Independent samples t tests and chi- square test (or Fisher exact test) were used to assess the differences between subgroups. Multiple logistic regression model was applied to evaluate independent predictors of SCF phenomenon.

In this study, 172 (1.43%) patients with SCF phenomenon were identified. Patients with SCF were more likely to be obese (27.58±3.28 vs. 24.12±3.26, P<0.001), hyperlipidemic (44.2 vs. 31.7, P<0.001), hypertensive (53.5 vs. 39.1, P<0.001), and smoker (37.2 vs. 27.2, P=0.006). Mean ejection fraction (EF) (51.91±6.33 vs. 55.15±9.64, P<0.001) was significantly lower in the patients with SCF compared to the healthy controls with normal epicardial coronary arteries. Mean level of serum triglycerides (162.26±45.94 vs. 145.29±35.62, P<0.001) was significantly higher in the patients with SCF. Left anterior descending artery was the most common involved coronary artery (n = 159, 92.4%), followed by left circumflex artery (n = 50, 29.1%) and right coronary artery (n = 47, 27.4%). Body mass index (BMI) (OR 1.78, 95% CI 1.04-2.15, P<0.001) and hypertension (OR 1.59, CI 1.30-5.67, P=0.003) were independent predictors of SCF phenomenon.

The prevalence of SCF in our study was not different from the most other previous reports. BMI and hypertension independently predicted the presence of SCF phenomenon.

The problem of dysmenorrhea has not yet been controlled despite the various managements available for it. Among those, a health-promoting lifestyle is recognized as a key factor to prevent the progression of many diseases since health promotion are directly related to lifestyle-related behaviors. This study assessed predictors of health-promoting lifestyle among university students with primary dysmenorrhea.

This cross-sectional study was conducted on 370 students with primary dysmenorrhea from October to February 2018. The subjects were selected from the students of the Islamic Azad University, Tabriz, Iran, using a proportionate stratified sampling method. The instruments used to collect data consisted of a demographic questionnaire, Beck Depression Inventory-II, General Self-efficacy Scale, and the Health-Promoting Lifestyle Profile II. The general linear model was used to estimate the impact of each independent variable on the dependent variables using SPSS software (version 21).

The mean scores of health-promoting lifestyle, general self-efficacy, and depression were obtained as 141.16±18.41, 57.81±8.1, and 11.8±10.5, respectively. There was a significant relationship between health-promoting lifestyle with self-efficacy and depression (p <0.001). Based on the general linear model, the relationship of the total score of a health-promoting lifestyle was significant with the general self-efficacy, depression, and regular physical activity (p <0.05). Students with high self-efficacy, low depression, and regular physical activity achieved higher health-promoting lifestyle scores.

It is recommended thatschools’ health policymakers should consider physical activities and psychological factors through offering educational and cultural programs, as well as paying greater attention than before to these dimensions.