فهرست مطالب

  • Volume:21 Issue: 18, 2020
  • تاریخ انتشار: 1399/03/21
  • تعداد عناوین: 7
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  • Zahra Davoudi, Arezoo Chouhdari*, Mahshid Mir, Fatemeh Akbarian Page 1
    Background

    Insulin therapy refusal among type 2 diabetic patients is most challenging for healthcare providers.

    Objectives

    This study aimed to evaluate the type 2 diabetic patients’ attitude and compliance with the initiation of insulin therapy.

    Methods

    A cross-sectional study was conducted on 100 type 2 diabetic patients at the Endocrinology Clinic of Loghman Hakim Hospital, Tehran, Iran. A questionnaire was prepared to assess the attitudes toward the onset of insulin therapy. Positive and negative attitudes toward insulin injection were compared between the two groups of accepting and rejecting insulin therapy.

    Results

    In this study, 62% of patients with type 2 diabetes tended to start insulin therapy. There was a statistical difference between the total positive and negative attitude items toward insulin therapy (agree/disagree) and acceptance of insulin therapy (P < 0.05). The most agreements related to a positive attitude in the two groups of accepting and rejecting insulin therapy belonged to statements “Insulin injection prevents complications of diabetes (micro and macrovascular)” as 100% (P < 0.001) and “Insulin injection helps improve my diabetes” as 96.8% (P < 0.001). The most agreements related to negative attitudes in the two groups of accepting and rejecting insulin therapy belonged to statements “Insulin injection causes my dependence on it” as 72.6% (P = 0.001) and “I can control my diabetes with oral medication and diet without insulin injection” as 97.4% (P < 0.001).

    Conclusions

    As 38% of patients with type 2 diabetes refused to initiate insulin therapy, it seems that effective communication between physicians and patients and continuous follow-ups by health care providers can increase positive attitudes toward insulin injection.

    Keywords: Insulin_Attitude_Compliance_Type 2 Diabetes
  • Katayoun Salehi, Zohreh Mahmoodi *, Kourosh Kabir, Alireza Jashni Motlagh Page 2
    Background

    Pregnancy may be the only time that a woman presents for medical care and when an opioid use disorder can be identified and treated.

    Objectives

    The aim of this study, determination of maternal and neonatal outcomes in mothers using opioids.

    Methods

    This prospective cohort study was carried out on 159 pregnant women who used opioids and 474 healthy subjects in Kamali Hospital in Karaj from 2014 to 2017. The data were collected using a checklist, containing social, midwifery, obstetric, and neonatal data. Data were analyzed by SPSS 19.

    Results

    In the present study, there were no significant differences between the two exposed and non-exposed groups in terms of mean age, pregnancy/maternal characteristics; however, there were significant differences in terms of weight gain and care services (P < 0.001). The frequency of all kinds of drugs; Methamphetamine with 27.7%; heroin with 25.8%; and opium with 24.5% were the most consumed drugs. Among the newborns in the two groups, the first and fifth minutes of Apgar score, weight, and admission were significant (P < 0.001). The prevalence of infants less than 2500 in the group faces 21.4% in contrast to 3.4% in the non-exposed group.

    Conclusions

    Given the increasing number of mothers consuming Opioids within pregnancy and the irreparable side effects of these drugs, it is important to pay attention to this and to provide coping strategies.

    Keywords: Neonatal, Outcomes, Opioids, Maternal
  • Alimohammad Bananzadeh, Seyed Vahid Hosseini, Hajar Khazraei, MohammadMehdi Lashkarizadeh, Leila Ghahramani *, Seyed MohammadKazem Tadayon, Mozhdeh Zamani, Zahra Zabangirfard Page 3
    Background

    Bariatric surgery has resulted in body weight loss, which claimed by surgery removal specific parts of the stomach with enzyme or sleeve gastrectomy.

    Objectives

    The aim of this study is to determine weight loss and endocrine changes by 12-week fundus resection and sleeve gastrectomy in rabbits.

    Methods

    Twenty-one rabbits, weighing 2.5 - 3.5 kg, were divided into three groups (n = 7): sleeve gastrectomy, experimental fundus resection, and sham group. The weight of rabbits and total ghrelin and leptin levels in the plasma before and after surgery were measured in 12 weeks. Statistical analyses were performed using the Kruskal-Walis test for comparison of the means between the groups, and the difference after months in one group was assayed by Friedman test.

    Results

    The results showed sleeve gastrectomy had a significant weight loss after one month when compared to fundus resection and sham-operated controls (P = 0.008). There was no significant difference in the ghrelin levels after these surgeries, but leptin levels decreased significantly after the fundectomy (P = 0.025).

    Conclusions

    Sleeve gastrectomy is more efficient than the fundus resection in weight loss. It could be suggested as a new option in metabolic disorders due to the high level of leptin.

    Keywords: Leptin, Ghrelin, Weight Loss, Sleeve Gastrectomy, Fundectomy
  • Mehdi Jahangiri, Amirreza Mostafavi, Alireza Choobineh, Mahnaz Shakerisn, HamidReza Tabatabaei, Forough Zare Derisi * Page 4
    Background

    Despite huge advances in science, technology, and medical equipment, numerous concerns grow over healthcare workers (HCWs) since they are exposed to a wide range of biological hazards due to the nature of their work.

    Objectives

    The current study aimed at developing and validating an index to assess the risk of occupational safety and health (OSH) in hospitals and healthcare settings.

    Methods

    In the current cross-sectional study, an index called the hospital occupational safety, and health risk assessment (HOSHRA) was developed and validated through the face and content validity as well as internal consistency and inter-rater reliability. Ultimately, the developed index was utilized to assess OSH risks in 36 teaching hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran.

    Results

    The mean score of the HOSHRA index among the selected hospitals was 71.53 ± 5.93, indicating that the OSH risks were at a moderate level. According to the HOSHRA action levels, OSH risk level for ergonomic hazards was high, but it was moderate for physical, chemical, ergonomic, and psychological ones. In terms of physical hazard subcategories, the risk of electrical hazard, as well as fire and explosion, was high, but it was moderate for fall and slip, and radiation.

    Conclusions

    The developed observation-based method showed an acceptable content validity and reliability for OSH risk assessment of hospitals. The HOSHRA index could also be used for hospitals as an applicable measure to improve their OSH.

    Keywords: Safety, Hospital, Risk Assessment, Occupational Health
  • Neda Hashemi*, Maryam Marzban, Bernadette Sebar, Neil Harris Page 5

    The current study aimed at validating the 26-item Suinn-Lew Asian Self-Identity Acculturation scale (SL-ASIA) using confirmatory factor analysis (CFA) in first-generation young adult Middle Eastern (ME) migrants, and also exploring the agreement between the outcomes of linear and orthogonal approaches of acculturation using SL-ASIA. The CFA and convergent and discriminant validity measures were employed to validate the original linear SL-ASIA and the subsequently designed orthogonal SL-ASIA for first-generation young adult ME migrants in Australia (n = 382). Cohen’s Kappa coefficient was used to measure the agreement between classifications obtained by the linear and orthogonal methods of measuring acculturation. The CFAs of the initial six-factor 21-item linear scale and the two-factor five-item orthogonal scale indicated poor fits. However, after model specification and validation, satisfactory fit and validity indices were achieved for the modified scales. The validated linear SL-ASIA comprised five factors and 15 items, and the validated orthogonal SL-ASIA comprised two factors and four items. The Kappa coefficient showed a high level of consistency between the linear and orthogonal models of acculturation, confirming that the use of either scale can lead to similar research outcomes. The study also supports the use of the validated linear and/or orthogonal scales to measure acculturation. This finding responds to the existing gap in the literature that until now, no acculturation scale is validated for ME migrants, and also no study is conducted to validate the orthogonal SL-ASIA.

    Keywords: Factor Analysis, Psychometrics, Acculturation, Statistical, Young Adult, Transients, Migrants, Australia, Weights, Measures
  • Shima Fakher, Payam Peymani, Saeid Ghavami, Pooneh Mokarram* Page 6
    Background

    The rapid spreading of corona virus disease 2019 (COVID-19) worldwide results in pneumonia and acute respiratory distress syndrome in many patients, which can be the major cause of death in cases with COVID-19. It has been reported that chloroquine (CQ) has improved COVID-19-induced pneumonia in clinical trials.

    Objectives

    Since CQ and its derivatives are proved to exhibit anti-autophagy properties based on previous studies, autophagy can be introduced as a possible mechanism of respiratory complications.

    Methods

    In the current study, we reviewed papers of Google Scholar database with no time limitation.

    Results

    It was revealed that autophagy has an important role in the manifestation of COVID-19 respiratory complications

    Conclusions

    Autophagy is triggered by SARS-CoV2 virus for its replication and autophagy inhibitory treatments might be considered promising therapeutics.

    Keywords: Therapeutics, Pneumonia, Chloroquine, COVID-19, Autophagy
  • Hesam Yousefi, Siamak Moayedi, Mehdi Harorani, Ali Sahebi, Mohamad Golitaleb* Page 7