Shiraz Emedical Journal
Volume:22 Issue: 10, Oct 2021

 Premenstrual syndrome is one of the common disorders in women, which occurs periodically in the luteal phase of the menstrual cycle. High blood pressure seems to be one of the problems that can occur with premenstrual syndrome.

 This study aimed to compare blood pressure changes in two groups with and without premenstrual syndrome.

 This is a descriptive-comparative study. The population of the study was the students of Tehran Islamic Azad University of Medical Sciences. Data were collected using a premenstrual syndrome screening questionnaire and blood pressure measurement that were then analyzed with SPSS at a significance level of α = 0.05.

 According to 1,408 questionnaires collected, 580 people had the premenstrual syndrome. Comparison of blood pressure before menstruation showed a significant difference between the two groups with and without premenstrual syndrome (P < 0.001).

 An increase in blood pressure in the group with premenstrual syndrome requires investigating hypertension and planning for educational programs for preventing and controlling blood pressure in people with premenstrual syndrome.

 Many people spend more than a third of their post-maturation on work. Thus, workplace environment and climate have a great impact on individuals' lifestyles, and work environment brings a health perspective that provides a healthier lifestyle for employees.

 The present study aimed to assess the staff's lifestyles and health behaviors as well as their relationship with organizational climate.

 This cross-sectional study was conducted on 404 employees from governmental departments in Shiraz in 2018. The data were collected using a three-part questionnaire, including demographic information, health-promoting lifestyle, and organizational climate questionnaires. Data were analyzed using the SPSS-25 software. Multivariate analysis of variance (MANOVA) was used to determine the significant relationship between demographic characteristics and organizational climate, and health-promoting lifestyle indices. The correlations between the lifestyle dimensions of health promotion and organizational climate were analyzed.

 Age, education level, work experience, gender, and type of organization were the effective factors in the perception of organizational climate. In addition, work experience, type of organization, and the organizational climate governing the workplace were the determinants of the health-promoting lifestyle. The results revealed a significant, positive, weak correlation between the health-promoting lifestyle and organizational climate. A significant correlation was also observed between self-actualization and organizational climate (r = 0.290, P < 0.001).

 It is necessary to identify which individual and organizational characteristics should be improved to support the organizational climate to improve the health-promoting lifestyle.

 Severe obstructive sleep apnea (OSA), defined by apnea-hypopnea index (AHI) as more than 30 events per hour, was previously related to more comorbidity. However, limited studies separated the patients with AHI > 100 from those with a less severe manifestation of the disease.

 The current study aimed at describing the characteristics of this subgroup and comparing them with less severe conditions.

 A retrospective analysis was conducted on 114 patients with OSA. Nocturnal polysomnography was used to diagnose severe OSA. Patients were categorized into two groups: (1) 60 < AHI < 100 (very severe OSA), (2) AHI ≥ 100 (extreme OSA). Demographic, medical history, and polysomnographic variables were evaluated and compared between the two groups.

 Extreme OSA was diagnosed in 19 patients, the mean body mass index (BMI) was significantly higher in this group (39.26 ± 5.93 vs. 35.68 ± 6.45 kg/m2, P = 0.025). They also had lower minimal O2 saturation (65.68 ± 10.16 vs. 74.10 ± 8.74, P = 0.003) and more time with < 90% O2 saturation (T < 90%) (81.78 ± 22.57 vs. 58.87 ± 33.14, P = 0.01). OHS prevalence was significantly higher in the group with extreme OSA (P = 0.04). The most frequent comorbidity was hypertension, with an incidence of 60.5%, for the extreme group, although there was no significant difference between the two groups in terms of clinical associations.

 The current study results suggested that greater BMI and lower minimal O2 saturation, as well as increased T < 90%, were associated with extreme OSA, although no differences were observed in the associated diseases between the compared groups.

 The effect of delirium of hospitalized inpatients on post-discharge cognitive status and survival of older patients remains unclear, and little is known about the related risk factors of cognitive impairment after delirium.

 To determine one-year survival of patients with delirium and cognitive dysfunction in elderly inpatients after initial hospital admission.

 This prospective cohort study was conducted on 100 patients with delirium admitted to a general hospital from October 2018 to November 2019. Cognitive dysfunction and death were the primary outcomes. The mini-mental state examination (MMSE) was used to measure cognitive function.

 In this study, 12 patients died in hospital and cumulative three-month mortality was 40%. Finally, 60 patients were followed for one year. The one-year survival rate through the Kaplan-Meyer approach was 31%. The rate of one-year mortality was found with a significant association with underlying parameters, such as cancer (P = 0.008), cirrhosis (P = 0.04), trauma (P = 0.001), BUN ≥ 50 mg/dL (P = 0.02), Cr ≥ 1.2 mg/dL (P = 0.04), hypocalcemia (P = 0.0), and thrombocytopenia (P = 0.002). According to the MMSE scores, participants had normal cognition (46.7%), mild dementia (6.7%), moderate dementia (33.3%), and severe dementia (3.3%). The cognitive impairment showed a significant association with underlying parameters, such as pulmonary infections (P = 0.02), trauma (P = 0.02), and renal failure (P = 0.04).

 Assessment and screening for delirium is necessary in all older hospitalized inpatients. Cognitive measurement is effective to identify delirium, accelerate proper control, and decrease its negative effects. Family members should be trained and involved in care, particularly for monitoring of risk factors upon discharge.
 

 The American Diabetes Association defines gestational diabetes as no glucose tolerance in the second or third quarter of pregnancy. Gestational diabetes imposes a huge economic burden on the health system. Diagnosis of gestational diabetes is important because it not only predicts prenatal disorders but also affects the long-term outcomes of the mother and child. Since screening tests are costly, it is necessary to find a cheaper method with an acceptable feature.

 The present study aimed to examine the costs of gestational diabetes screening in pregnant women referring to gynecology hospitals affiliated with medical sciences universities in Tehran.

 This was a descriptive-analytical study conducted in the selected hospitals affiliated with medical sciences universities in Tehran in 2016. The study population included all the pregnant women with no risk factors, referring to the selected centers. A multi-stage random sampling model was utilized, and the sample size was 392. The data were gathered through the forms designed for recording costs, as well as interviews, and were analyzed using SPSS18 software, t-test, and one-way ANOVA.

 The mean direct medical costs, direct non-medical costs, and indirect costs of the one-step method were $516,960, $71,593, and $142,162, respectively. Also, the mean direct medical costs, direct non-medical costs, and indirect costs of the two-step method were $262,890, $46,536, and $28,621, respectively.

 The screening of pregnant women using the two-step method is cheaper to diagnose diabetes. The results of this study recommend gynecologists to use the two-step method to diagnose gestational diabetes with lower costs.

 The ability to acquire, process, and understand health information to make informed decisions about health is defined as health literacy. A low level of health literacy disrupts women’s ability to understand and use health information in order to take appropriate and timely measures during pregnancy.

 Due to the importance of health literacy during pregnancy and its direct impact on fetal health, this study was conducted to determine the level of health literacy and its related items among the pregnant women referred to medical and health centers in Tehran.

 This descriptive-analytical study was conducted on 270 pregnant women referred to the medical and health centers of Tehran in 2019. The participants in this study were selected by the mixed sampling method (cluster and random methods to select health centers and the convenience method to select participants). Data collection tools included a questionnaire for demographic and midwifery characteristics and a specialized questionnaire for maternal health literacy in pregnancy (MHELIP). Data analysis was performed by SPSS-19 software.

 The mean age of the participants was 28.16 ± 5.70 years, and the mean gestational age was 24.50 ± 9.25 weeks. The mean score of health literacy among pregnant women was 63.14 ± 9.63, and 48.9% of them had limited (inadequate and insufficient) health literacy. The results showed positive correlations between the total score of health literacy and the demographic variables of age (P = 0.025), education (P = 0.003), and income (0.008), but no significant relationship was found between the mean total score of health literacy and employment status (P = 0.614) or parity (P = 0.614).

 It was found that limited health literacy had a high prevalence among pregnant women. Given the importance of pregnancy, it seems necessary for healthcare policymakers to design programs to promote women’s health literacy during pregnancy.

 The occurrence of an earthquake in Kermanshah province in 2017 leads to death and injury of its inhabitants. Assessment of the health system functions can lead to the provision of the necessary healthcare services for the affected population post-disasters. The present study is aimed to assess the health system functions after the Kermanshah earthquake.

 Assessment of health system functions in the reproductive, pediatric, and environmental health dimensions in the affected regions of Kermanshah were the research objectives.

 This mixed methods study was conducted in the two phases of developing a tool and assessment of the main health system functions. Content validity and reliability were measured by CVR and CVI, and Cronbach's alpha, respectively. Assessment of health system functions was conducted by the participation of 100 affected households.

 Firstly, the primary tool was designed using 31 primary items extracted from literature review and a qualitative study. CVR and CVI of the tool were 100%, and Cronbach's alpha was 0.97. The coverage of the reproductive, environmental, and children’s health services ranged from 90 to 100% since the first day to one year after the earthquake and between 30 and 60% from one year to two years post-earthquake.

 The assessment of health system performance can provide the necessary data for effective decision making and promoting health system functions. Further research is needed to assess the functions of the health system after other natural disasters rather than earthquakes.
 

 Prevention of death in patients on the waiting list for liver transplantation (LT) is a major concern to prioritize organ allocation. Since the model for the end-stage liver disease (MELD) and its modifications have many shortages, there is a need for further refinement of the allocation strategy.

 The current study aimed at assessing the predictors of mortality in LT candidates in a more comprehensive manner with the possible implications to improve the care of such patients and assist in developing better strategies for organ allocation.

 In the current cohort study, 544 adult LT candidates with end-stage liver disease were followed up for a mean of 12 months in three-month intervals. Data analysis was performed in Nutritionist, SPSS, and R software, using Kaplan-Meier, Cox proportional hazard (HRC), and LASSO Cox regression hazard (HRL) tests.

 The mean age of the patients was 46.7 ± 13.7 years; the majority were male (n = 336, 61.7%). At the end of the study, 414 (76.1%) subjects were still alive and 130 (23.9%) dead. The cumulative percentages of death were 33.1%, 57.7%, and 79.2% after 3, 6, and 12 months of waiting for a donor, respectively. Although there was a strong association between having hepatopulmonary syndrome (HPS) (HRC = 4.7, HRL = 1.8), a history of myocardial infarction (MI) (HRC = 3.3, HRL = 1.6), low-carbohydrate (CHO) diet (HRC = 2.7, HRL = 1.5), and mortality, it was weak for MELD score. Moreover, a serum level of CA 125, high polymorphonuclear (PMN) count, weight loss, a high level of alanine aminotransferase (ALT), positive hepatitis B virus (HBV) markers, high mean corpuscular volume (MCV) of red blood cells, ascites, and edema of gallbladder wall had association with mortality in LT patients.

 In addition to MELD score, HPS, a history of MI, low CHO intake, weight loss, ascites, PMN, CA 125, ALT, hepatitis B surface antigen, MCV, blood urea nitrogen, and gallbladder wall thickness are predictors of mortality in LT candidates and need to be considered in the LT allocation system.

 Stressful workplace experiences of police officers predispose them to physical and psychological injuries and affect their quality of work-life (QWL).

 Therefore, this study aimed to examine the QWL of Iranian police officers.

 This descriptive cross-sectional study was conducted in 2020 on 200 police officers working in different job positions of the Iranian Police Organization. A convenience sampling method was used to recruit the participants from 12 police departments in five cities. The Police Quality of Work-life questionnaire (PQWLQ) was used for data collection. The measures of descriptive and inferential statistics (independent-samples t-test, one-way analysis of variance, and Pearson correlation coefficient) were used for data analysis.

 Of the 200 police officers, 87.5% (175) were males, 68% (136) had a bachelor’s degree or higher, and their work experience ranged between five and 27 years. The QWL score of the study participants ranged from 24 to 120 with a mean (± SD) of 63.20 (± 18.40), and the majority of them (56%) had a moderate QWL. Male police officers had a higher QWL (67%) than female ones (45%) (P < 0.05).

 The majority of the police officers who participated in this study had a moderate QWL. To increase the level of QWL among police officers, the Police authorities should plan appropriate strategies and programs.
 

Childbirth causes intense emotional arousal that may cause traumatic psychological symptoms in some women. This study investigated the prevalence of post-traumatic stress disorder (PTSD) in women with normal vaginal delivery and those with caesarian section. This was a cross-sectional study conducted in selected health centers affiliated to Shiraz University of Medical Sciences in 2018. The samples included 714 patients (328 vaginal deliveries and 386 cesarean deliveries). Sampling was performed using the convenience sampling method in two cluster stages after selecting the clinic. Mothers were determined to be traumatic in their delivery according to criterion A in the Diagnostic and Statistical Manual of Mental Disorders Version DSM-IV (with four questions). Then, a demographics checklist and a stress disorder questionnaire were filled out for all the mothers after a traumatic delivery through interviews. The prevalence of postpartum stress disorder was higher in the cesarean section group (10.8%) than in the normal vaginal delivery group (10%), but this difference was not significant (P = 0.275). Although the prevalence of PTSD between the two groups was not significant, the prevalence of PTSD was significantly higher in this study than in reports from other countries. This highlights the need for targeted interventions to reduce this disorder.