نشریه پژوهش سلامت
سال ششم شماره 4 (پیاپی 24، تابستان 1400)

Skin manifestations play a very important role in the diagnosis of various infectious diseases.

A 67-year-old woman with fever (39.2° C), fatigue, muscle weakness, and shortness of breath referred to the Medical Emergency Department of Tehran Hospital. From three days before his hospitalization, he had oral ulcers on the back of the tongue and buccal mucosal ulcers, erythematous macules, as well as papules on the palms of the hands, feet, and legs.

Pulse rate, respiration rate, blood pressure and oxygen saturation were 122 beats per minute, 18 beats per minute, 119.78 mm Hg and 91%, respectively. Covid-19-positive or real-time polymerase chain reaction was confirmed with his pharyngeal swab. Chest CT scan showed segmental pneumonia in both lungs with moderate involvement. Laboratory tests significant levels of di-dimer (3.5 μg/L), lactate dehydrogenase (469 mg/L), C-reactive protein (121 mg/L), lymphocyte count (87%) and troponin (065.0 ng/ml). Prothrombin time (17 seconds), partial thromboplastin time (45 seconds), and levels of alanine aminotransferase (69 units per liter), alkaline phosphatase (426 units per liter), ferritin (475 ng / ml) and creatinine (1.85 ml) G per deciliter) was assessed. Loratadine and nystatin were administered for 5 days to treat local pruritus and mucosal lesions, respectively. Finally, after recovery on the sixth day of hospitalization, she was successfully discharged from the hospital under stable conditions with 96% oxygen saturation.

This study showed that erythema multiform can be a new skin manifestation caused by the Covid-19 infection.

Carotid body tumors are rare tumors of the head and neck that arise from a chemical receptor organ and their cause is unknown. But it seems that living at high altitudes can increase the incidence of these tumors.

This research was the result of a study on a series of recorded cases of carotid body tumors. Recorded data from 100 patients with carotid body tumors were collected between 2014 and 2016. Data analysis was performed in SPSS software and quality and percentage data were reported for quality data and mean and standard deviation for quantitative data.

In this study, the mean age of the total affected population (24 12.24) was 51.74. The prevalence of carotid body tumors was higher in women than men (78% vs. 22%). Also, carotid body tumors were mostly unilateral (90% vs. 10%) and the frequency of tumors on the right was higher than on the left (51% vs. 37%). All patients in our study underwent surgical resection and the overall survival was 100%.

Carotid body tumors are rare and almost asymptomatic tumors in the head and neck that are mainly seen in non-smokers with a mean age of 51 years. Surgery is one of the treatment options for these tumors. But radiotherapy may also be used as an alternative method.

Referral chain and its efficiency in different levels of health care system leads to optimal use of manpower and equipment. The purpose of this study was to explain the management challenges in establishing an electronic referral system.

A qualitative study was conducted in Golestan province (Iran) in 2009 with inductive content analysis approach. Participants in the study were family physicians and specialists, managers and experts in charge of electronic referral system in the Deputy of Health, Deputy of Treatment, Department of Statistics and Information Technology, General Department of Health Insurance of the province who were purposefully selected. Data were collected during 39 semi-structured interviews and analyzed by content analysis using Atlas.ti 8 software.

The management challenges of Golestan province referral system were classified into 5 main categories (planning, coordination, organization, leadership and motivation, control and supervision) and 28 sub-categories.

The need to pay more attention to the management challenges resulting from the study and selection of appropriate strategies to improve the current situation, can lead to a quantitative and qualitative improvement of the patient referral system.

Content is the main factor in attracting the audience especially for health-oriented TV shows. The aim of present study is to compare the content of health-related TV shows of “NOSKHEH’’ from IRIB TV1 and “37 Degrees’’ from BBC Persian to present and optimal guideline of content production for IRIB health-related TV shows.

14 episodes of a total of 216 episodes of "NOSKHEH" and "37 degrees" TV shows have been selected through systematic sampling method. The collected data were analyzed using qualitative content analysis method.  

In terms of interactive ways, 37 degrees used five various ways compare to two ways was employed in NOSKEDH. Looking at variety of issues, 37 degrees covers different content with the other program. That is, while the BBC Persian program paid attention to physical, mental, and sexual health, the IRIB TV1’s program covered physical health only.

Using the variety of content creating and using interactive ways with the audience, IRIB TV shows has to pay enough attention to divers and up-to-date methods of two-way interactions as well as covering other aspects of health rather than only physical health. These can potentially improve the quality and increase the audiences of IRIB health-related TV shows.
 

Exercise should be considered as the front line of necessary measures to reduce pregnancy complications and increase the physical health of mother and child. Women reduce the intensity and duration of their physical activity due to concerns about the possibility of physical adverse effects on fetal health. Awareness of not harming the fetus through exercise reduces the mother's stress and increases her desire to exercise. This study was performed to evaluate the effect of pregnancy exercise on placental and fetal health and function. Findings indicate that the effect of exercise depends on the type, frequency, intensity and duration of exercise as well as the time of exercise during pregnancy. Despite the differences in the design of studies, so far there is no report on the negative impact of exercise on fetal health. Most studies emphasize the benefits of exercise by increasing lean mass and decreasing fat mass, reducing basal heart rate, and increasing fetal heart rate variability, and believe that exercise is also effective in future child health. Due to the positive effect of exercise on fetal health, in the absence of obstetric problems, it should be considered as an important part of prenatal care.  

The family physician as a decision maker in the health of the region and the community covered should have the necessary knowledge and ability to make appropriate and logical decisions based on the protocols and instructions of the ministry in the family physician plan and referral system. The purpose of this study was to evaluate the quantitative and qualitative status of the family physician plan from the perspective of family physicians, health team members and staff experts.

This descriptive cross-sectional study was performed. The sample included family physicians (67 people) working in the health care network of Golestan province (Iran) and members of the health team (290 people) in 1399. For quantitative evaluation, the lean system was referred to and in the qualitative evaluation section, a researcher-made questionnaire including demographic information and examination of different dimensions of the family physician program was designed for each group of physicians and members of the health team.

The satisfaction of physicians and health team was above average (0.51 and 0.54, respectively). The lowest level of satisfaction in both groups in terms of salaries and benefits and the highest in physicians related to the registration and reporting system and in the health team related to the monitoring and evaluation system.

The family physician plan in the planning, implementation and evaluation phase is not without its drawbacks and has challenges that warn the need for policy makers to make reforms.  

Using testosterone by athletes (especially in resistance training) to improve recovery and muscle growth has become common. But considering the side effects, it seems necessary to find alternative methods.

Thirty male rats were divided into six groups (n=5): exercise training, phoenix dactylifera extract, testosterone, phoenix dactylifera extract + exercise training, and testosterone+ exercise training. The exercise training groups performed a resistance training program (five sessions per week, each session, starting with 50% of a maximum repetition and increasing the intensity of training to disability) for four weeks. Phoenix dactylifera extract (5 days a week at a dose of 100 mg per kg body weight) was fed to rats in the phoenix dactylifera groups for four weeks. Rats in the testosterone groups also received testosterone enanthate for four weeks (five days a week at a dose of two milligrams per kilogram of body weight). Forty-eight hours after the last intervention, the animals were sacrificed and the gastrocnemius muscle were removed to measurements of the FOXO3α and beta-catenin 1 (Ctnnβ1) gene expressions, as well as, the ratio of apoptotic cells.

Exercise decreased FOXO3α gene expression and the number of apoptotic cells in the gastrocnemius muscle (P=0.001). The combination of testosterone and phoenix dactylifera decreased the expression of FOXO3α (P=0.001) and Ctnnβ1 (P=0.004) genes as well as the number of apoptotic cells (P=0.001) in the gastrocnemius muscle. The rate of gastrocnemius muscle apoptotic cells in the interactive groups (exercise + testosterone and exercise + phoenix dactylifera) was lower than the independent groups (exercise, testosterone and phoenix dactylifera) (P=0.001).

The present study suggests the positive effect of phoenix dactylifera on the expression of FOXO3α and Ctnnβ1 genes, as well as, the amount of apoptotic cells in the gastrocnemius muscle. So, phoenix dactylifera may be considered as a natural alternative to testosterone.

Home quarantine to prevent the spread of Covid 19 has a number of psychological consequences, including feelings of loneliness that can have long-term negative consequences. The purpose of this study was to review studies on loneliness caused by Covid-19.

This study was a systematic review study. Articles published in 2020 (until August 10) using the keywords of Corona virus, loneliness, social isolation, mental health, Covid-19 and quarantine and by searching on reputable sites Pabmed, Science Direct, Google Scholar, Sage, Proquest Performed in the presentation of coronavirus, Covid-19 and alone. After screening, finally 33 original studies were obtained which were examined in terms of research quality and methodology. Finally, 14 articles were included in the research and analyzed.

At the time of the outbreak of Covid-19, 29.2% of the subjects showed signs of psychiatric disorders and 35.86% of the subjects experienced feelings of loneliness. Longitudinal findings as a safer way to explore feelings of loneliness over time showed that the elderly (over 65), the chronically ill, and those who lived alone before Covid-19 were at higher risk of loneliness. . Risk factors for feeling lonely include low economic status, female gender, younger people, having at least once Covid-19, weaker and older self-perception, low social support, and protective factors including employment, living with a spouse, Self-compassion, spiritual well-being, was a sense of social belonging.

Feeling lonely in quarantine is not a prevalent feeling, and health policymakers need to plan based on the individual characteristics of those at risk. These programs are better designed for the elderly (over 65), young people (under 30) and women to save them from the risk of health problems caused by loneliness.