فهرست مطالب

Shiraz Emedical Journal - Volume:20 Issue: 6, 2019
  • Volume:20 Issue: 6, 2019
  • تاریخ انتشار: 1398/03/12
  • تعداد عناوین: 8
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  • Vida Ghasemi , Masoumeh Simbar *, Giti Ozgoli , Seyed Massood Nabavi , Hamid Alavi Majd , Behzad Mohammad Souri , Farzaneh Rashidi Fakari , Marzieh Saei Ghareh Naz Page 1
    Context
    Sexual dysfunction is one of the most common symptoms in women with multiple sclerosis (MS), which has a great impact on the individuals’ quality of life, and is usually neglected. The present study was conducted with the aim of studying the prevalence of sexual dysfunction in Iranian women with MS.
    Evidence Acquisition
    All Iranian articles published between 2000 and June 2018 in Persian and English were collected by using standard keywords in national and international databases. After evaluating articles based on inclusion/ exclusion criteria and quality assessment, related articles were selected. Heterogeneity of the studies was evaluated using the I2 index and the publication bias was assessed using the Egger and Begg tests. Data analysis was performed in STATA software version 11, 1 by using random effect model.
    Results
    Eight studies with a sample size of 1,301 people entered in this meta-analysis. The overall prevalence of sexual dysfunction in women with MS was 62% (CI: 95%, 51% - 73%). In addition, the prevalence of sexual dysfunction by using female sexual function index (FSFI) was 57% (CI: 95%, 46% - 68%) and by using multiple sclerosis intimacy and sexuality questionnaire-19 (MSISQ-19), was 73% (CI: 95%, 55% - 91%).
    Conclusions
    The results of the present study were indicative of a prevalence of 62% for sexual dysfunction in Iranian women with MS. Considering the high prevalence of sexual dysfunction and its impact on the quality of life of these women, it seems essential for treatment teams to pay attention, plan, and design effective interventions in this regard.
    Keywords: Multiple Sclerosis, Sexual Dysfunction, Prevalence, Meta-Analysis, Iran
  • Amin Babaei Pouya *, Zeinab Mosavianasl , Eslam Moradi, Asl Page 2
    Background
    Neonatal intensive care unit (NICU) is a critical unit in terms of nursing care with a high risk of error incidence.
    Objectives
    This research aimed at determining the type of nursing task mistake, the risk level of the nurse’s duties, and assessing the probability of human error in the duties of the nurse.
    Methods
    This research was a case study. The location of NICU research was Alavi and Bouali Hospitals in Ardabil University of Medical Sciences in 2018. The study was performed using HTA, SHERPA and SPAR-H methods.
    Results
    Having analyzed the occupational hierarchy, 17 main tasks and 35 subtasks were identified and studied in NICUs. Among 156 error cases, 43.59% were action errors (highest frequency) and 8.97% were selection errors (lowest frequency). The most common errors in terms of the type of task and probability of errors were “air and respiratory ventilation”, “thermal and respiratory monitoring”, “examination, evaluation and control of the newborn’s pain”, and “administering drugs”.
    Conclusions
    The factors affecting performance such as time, psychological and physical stress, workload, work complexity, mental effort, experience and education, instruction, ergonomics principles, work planning, safety culture, management policy, and organizational support had the greatest impact on the probability of nurse errors.
    Keywords: Intensive Care Unit, Human Errors, Nurse
  • Babak Vahdatpour , Shila Haghighat , Zahra Azimi *, Hadiseh Ramezanian Page 3
    Background
    Carpal tunnel syndrome (CTS) is the most prevalent entrapment neuropathy occurring due to increased pressure in the carpal tunnel.
    Objectives
    The study aimed to evaluate the degree of symptom improvement, safety, and the change in electrophysiological findings after ultrasound (US)-guided versus Landmark (LM)-guided local steroid injection for the treatment of CTS.
    Methods
    This randomized clinical trial recruited 52 patients with moderate or moderate-to-severe CTS. The subjects were randomly assigned to US-guided or LM-guided corticosteroid injection groups and received 40 mg methylprednisolone. After four weeks and 12 weeks of treatment, the patients were evaluated using the Boston questionnaire and electrophysiological parameters were determined.
    Results
    All variables, including symptom/functional scores and electrophysiological findings, improved significantly in both groups after four weeks (all P < 0.05), except for compound muscle action potential (CMAP) amplitude in the LM-guided group. The LM-guided group showed a regress in all variables in the 12th week compared to the 4th week; however, these improvements persisted at week 12 post-treatment in the US-guided group (P < 0.05), except for the functional status scale (FSS) and sensory nerve action potential (SNAP). The improvement in the CMAP amplitude at week 12 was more in the US-guided group than in the LM-guided group (P < 0.05); however, the SNAP amplitude and SNAP nerve conduction velocity (NCV) improved more significantly in the LM-guided group. Significant differences were not observed between the groups with respect to the symptom severity score (SSS), FSS, SNAP latency, and CMAP latency at weeks 4 or 12 after treatment (P > 0.05).
    Conclusions
    The symptom severity, functional status, and all electrophysiological parameters improved significantly in both US-guided and LM-guided corticosteroid injection groups and generally, no statistically significant difference was observed between both methods.
    Keywords: Carpal Tunnel Syndrome, Corticosteroids, Ultrasound, Injection, Electrodiagnosis
  • Mojtaba Salimi , Abedin Saghafipour *, Hadi Hamidi Parsa , Majid Khosravi , Mohammad Reza Shirzadi Page 4
    Background
    Cutaneous leishmaniasis as a prevalent sandfly borne disease in many tropical and subtropical countries has adverse economic consequences for patients and health care systems.
    Objectives
    The aim of present study was evaluation of the economic burden of cutaneous leishmaniasis on families and consequently the health care systems in all of 31 provinces of Iran for year 2017.
    Methods
    This cross-sectional study was carried out based on available data from 14125 cutaneous leishmaniasis cases in all endemic foci of Iran in 2017. The direct and indirect costs paid by patients and government health care systems were extracted through accounting documents via patients and health staff in the office of zoonotic diseases control, CDC, Iranian Ministry of Health. The data was recorded in researcher-made forms. Activity based costing (ABC) is used to evaluate economic burden of health care services in Iran to patients with of CL. Two financial software suites namely Azarakhsh and Roozamad have been employed in addition to Excel V. 2010.
    Results
    The incidence of cutaneous leishmaniasis in Iran was 17.82 per 100,000 people (14125/79,262,000). Economic burden of the disease was estimated at 291,046,430,125 Rials ($ 5,820,928). The average direct, indirect (overhead) and governmental costs paid for each case with CL was 10,631,250 Rials ($ 212.5), 9,653,807 Rials ($ 193) and 20,285,057 Rials ($ 405.5) respectively. The out of pocket for each patient was around 320 thousand Rials ($ 7). Total costs (governmental + out of pocket) during this period was estimated at 20,605,057 Rials ($ 412.5) expenditure per capita.
    Conclusions
    Direct and indirect costs associated with diagnosis and treatment of CL in Iran that was provided by governmental health care systems and out-of-pockets are considerably high. It can have a great economic impact on families and consequently the health care systems. It seems adopting suitable preventive methods will be more affordable for people who live at risk of the disease.
    Keywords: Cutaneous Leishmaniasis, Economic Burden, Incidence, Iran
  • Mojgan Mirghafourvand , Havin Zandinava , Fahimeh Sehhatti Shafaei , Sakineh Mohammad, Alizadeh, Charandabi , Solmaz Ghanbari, Homayi * Page 5
    Background
    Gestational diabetes is a specific problem during pregnancy and training may be effective in improving pregnancy outcomes.
    Objectives
    The purpose of the present research was to evaluate the effectiveness of self-care training on pregnancy consequences, which was performed in participants with gestational diabetes from January to May 2016.
    Methods
    This research was conducted on 92 primipara and multipara women (28 - 30 weeks of pregnancy) with gestational diabetes referred to the Tohid Hospital Diabetes Clinic in Sanandaj, Iran. Participants were randomly assigned to self-care training (n = 46) and control (n = 46) groups through blocked a randomization method. The training program included self-care training, especially physical activity and nutrition that planned in four sessions for experimental arm through lecture, question, and answer. The control group received only routine prenatal care. After the delivery, outcomes checklist (gestational age at the time of delivery, type of delivery, neonate anthropometrics indices) were completed in both groups. ANCOVA and Multivariate Logistic Regression tests were used to compare the quantitative and qualitative variables between groups with adjusting the variables of mother’s age and body mass index.
    Results
    Two study groups had no significant difference in terms of birth weight, height, and head circumference of their newborns (P > 0.05). There were statistically significant differences between groups in term of cesarean delivery (0.07; 0.02 to 0.23; P < 0.001) and macrosomia (0.05; 0.007 to 0.49; P = 0.009). However, there was no significant differences between groups in term of preterm labor (odds ratio (OR): 0.32; 95% confidence interval (CI): 0.10 to 1.02; P = 0.055).
    Conclusions
    Self-care training in women with gestational diabetes can reduce the rate of macrosomia and cesarean delivery.
    Keywords: Gestational Diabetes, Self-Care, Pregnancy Outcomes
  • Mohammadreza Ghasemi , Abbas Behzad Behbahani , Ali Farhadi *, Tahereh Pakdel , Mohammad Javad Ashraf Page 6
    Background
    Thyroid carcinoma, the most prevalent endocrine malignancy, has increased rapidly in recent decades. A single-base substitution in the BRAF gene is identified as the most common genetic event in thyroid carcinoma. Infections with both DNA and RNA viruses can induce chronic inflammatory diseases and cancer. Human parvovirus B19 (B19V) infection has been implicated in thyroid cancer as the most common inflammation of the endocrine system.
    Objectives
    The study aimed to determine the prevalence of the BRAFV600E gene mutation and the presence of B19V infection in malignant and non-malignant thyroid tissue samples.
    Methods
    A cross-sectional study was performed from January 2012 to December 2017 on 108 paraffin-embedded thyroid tissues from patients with thyroid cancer tumor and nodular goiter. After DNA extraction, PCR restriction fragment length polymorphism (PCR-RFLP) and nested PCR assays were used to detect the BRAFV600E gene mutation and B19V DNA in tissue specimens, respectively. To confirm PCR-RFLP reliability, the amplified products were subjected to DNA sequencing. Statistical analysis was performed to determine a possible correlation between the occurrence of BRAFV600E mutations and clinicopathological characteristics, such as tumor subtypes, gender, age, and B19V presence.
    Results
    Overall, BRAFV600E mutation was detected in 77 out of 108 patients (71.3%) using PCR-RFLP, confirmed by DNA sequencing analysis. Using nested PCR, human parvovirus B19 DNA was detected in 14 out of 108 (13%) of the formalin-fixed, paraffin-embedded (FFPE) tissue specimens. Statistical analysis showed a significant difference in the prevalence of the BRAFV600E mutation in thyroid cancer patients when compared with the control group (P ≤ 0.001).
    Conclusions
    Since cytological examinations depend on fine needle aspiration of the thyroid (FNAB) cannot be conclusive; hence it might be suggested that detection of the BRAFV600E gene mutation can be considered as a feasible assay. However, a low detection rate of the B19V DNA in FFPE tissue samples suggests that B19V infection is not associated with thyroid cancer.
    Keywords: BRAFV600E Mutation, Human Parvovirus B19, Thyroid Cancer
  • Maryam Nikbina *, Poorandokht Afshari Page 7
    Background
    Sexual activity and its satisfaction are the most fundamental dimension of human life and attention to this is an essential component of health care standards. There are several factors involved in the progression and development of female sexual disorders.
    Objectives
    The present study was conducted to evaluate sexual satisfaction and some of its related factors in Ahvaz city.
    Methods
    This is a descriptive-analytical and cross-sectional study. The sampling method was convenience sampling. It was carried out on 685 women referring to health centers in Ahvaz for other medical treatments. The data collection tool was a two-part questionnaire consisting of section A, containing personal details such as age, length of marriage, number of offspring, age of the youngest child, age of the spouse, and methods of contraception and section B, containing sexual satisfaction questionnaire. This scale for sexual satisfaction questionnaire was used to analyze the data between a score of 25 to 125.
    Results
    The sexual satisfaction recorded by 40.9% of the women was high, in 48.2% moderate, in 10.5% low, and 0.4% reported sexual dissatisfaction. Education has significant and prominent effects on sexual satisfaction.
    Conclusions
    According to the findings of the study, a relationship was shown between the demographic characteristics, the contraceptive methods, and sexual satisfaction. Therefore, the establishment of marital counseling classes in health centers seems necessary to enable women to improve sexual health issues and the use of group- or individual-treatment methods.
    Keywords: Sexual Satisfaction, Related Factors, Contraceptive Methods
  • Sepideh Abbaszadeh , Mehdi Jahangiri *, Soheil Hassanipour Page 8
    Background
    It is generally assumed that teachers lead healthy lifestyles; meanwhile, due to their specific working conditions, they stand among occupational groups exposed to a wide variety of health hazards associated with their profession.
    Objectives
    This study aimed to investigate the prevalence of work-related health problems in the teaching profession of Shiraz, Iran.
    Methods
    This cross-sectional study was conducted among 508 primary and secondary school teachers in Shiraz. The participants were chosen using a multi-stage sampling. On the basis of Subjective Health Complaints Inventory, a standard multi-section questionnaire was prepared for data collection. To analyze the data, chi-squared test was used in SPSS, version 19.
    Results
    A total of 508 questionnaires were returned by the primary and secondary school teachers. The results showed that 94.7% (n = 468; 95% CI [91.5 - 95.8]) of the respondents suffered at least one type of the 38 single complaints during the previous 30 days. The 10 most frequently reported health complaints among the teachers were lower back pain, tiredness, leg pain, voice disorder, headache, neck pain, anxiety, shoulder pain, varicose veins of lower limbs, and sleep problems. The 5 most severe complaints were tiredness, leg pain, lower back pain, voice disorder, and headache.
    Conclusions
    A wide variety of somatic health problems reported by studied teachers indicates the importance of preventive and rehabilitative measures rather than treatment. We hope that our results can raise the awareness of the government and respective organizations, such as the ministry of education to improve teachers’ working condition.
    Keywords: Iran, Prevalence, Subjective Health Complaints, Teachers, Work-Related Health Problems