Shiraz Emedical Journal
Volume:23 Issue: 3, Mar 2022

This study aimed to determine the prevalence of post-transplant lymphoproliferative disorder (PTLD) based on the clinical and epidemiological characteristics of donors and pediatric transplant recipients.

This cross-sectional study was conducted on the patients who had experienced liver transplantation at Shiraz Transplant Center, Shiraz, Iran, from April 2007 to March 2017. Data on the epidemiological characteristics, underlying diseases, dosage of immunosuppressive drugs, and duration of drug consumption from the time of liver transplantation until the onset of PTLD for transplant recipients, and donors’ age, sex, and family relationship with recipients were collected using a data-gathering form. Log rank test was employed to determine the variations in the distribution of survival in different sex and age groups.

The study findings indicated that 49 out of the 1207 children who had undergone liver transplantation developed PTLD, revealing a prevalence of 4%. The results showed no significant relationship between gender and the incidence of PTLD (P = 0.13). However, the mean age of the cases with PTLD was 4.93 ± 1.07 years at the time of transplantation, while non-PTLD patients showed a higher mean age at that time (7.80±5.54). The mean dose of the immunosuppressive drugs (dose/kg) consumed by the recipients was as follows: tacrolimus = 0.2753 ± 0.23435, prednisolone = 0.6761 ± 0.62218, cellcept = 0.0724 ± 0.12963, and sirolimus = 0.1078 ±0.08813. The average consumption period of the above-mentioned drugs from the time of transplantation until the onset of PTLD was 14.7 ± 14.409 months. Based on the results, the five-year survival rate was much lower in the patients with PTLD compared to the non-PTLD patients (31% Vs. 72.7%). The survival distribution was significantly different based on sex and age groups (P = 0.59 and P = 0.06, respectively).

The prevalence of the clinical and epidemiological features of the PTLD in the patients under the present investigation was similar to those of the patients in other hospitals. Recognizing the clinical and epidemiological characteristics of transplant recipients with and without PTLD and donors can provide a basis for managing these patients.

Metabolic syndrome (MetS) criteria consist of different but interconnected cardiovascular risk factors, including dysglycemia, hypertension, abdominal obesity, and dyslipidemia.

We aimed to determine the prevalence of MetS, its components, and related factors in the southern coastal area of Iran, Bandare-Kong Non-Communicable Diseases (BKNCD).

This population-based study was performed on the baseline data from participants of BKNCD, which has recruited participants from Bandare-Kong city, one of the 18 distinct geographical areas included in the Prospective Epidemiological Research Studies in IrAN (PERSIAN). MetS was diagnosed based on the National Cholesterol Education Program (NCEP) criteria and the Iranian-specific cut-off for waist circumference (≥ 95 cm). The socioeconomic status (SES) was estimated by multiple correspondence analysis (MCA) based on participants’ different properties.

Of 3,927 participants included in this study, 2,230 (56.8%) were female. Age-standardized prevalence of MetS was 34.5%. The most common MetS component was central obesity (45.1%), followed by decreased high-density lipoprotein (42.6%), elevated fasting plasma glucose (39.9%), elevated triglyceride (37.7%), and increased blood pressure (37.5%). Besides, 84.7% of the subjects displayed at least one component of MetS. Binary logistic regression analysis revealed that women aged 65 - 70 years were at higher risk of having MetS compared to those aged 35 - 39 years (adjusted odds ratio [aOR] = 23.37, 95% CI 7.54 - 20.30, P < 0.001). Also, living in rural areas was a risk for MetS in women (aOR = 1.55, 95% CI 1.18 - 2.03, P = 0.002). Employment and education were protective against MetS in women. Being overweight significantly increased the risk of MetS in both men and women. Obesity was more problematic for men (aOR = 16.66, 95% CI 11.65 - 23.81, P < 0.001) compared to women (aOR = 10.43, 95% CI 7.82 - 13.90, P < 0.001). Marital status, education, smoking status, and SES did not significantly predict MetS in men.

A high prevalence of MetS was observed in this study, emphasizing central obesity, high triglyceride, and low highdensity lipoprotein. This calls on the government authorities to establish screening programs to identify individuals with a lower number of abnormal MetS components to prevent them from developing MetS and the resultant cardiovascular complications.

The study and revision of postgraduates syllabus are very important aspects to promote the level of effectiveness of postgraduates’ educations. Owing to the requirement of syllabus reform, especially when the speed of useful life of information in the world is less than a decade, it is a serious aspect for the educational programmers.

This study aimed to determine the view of biostatistics graduates on the syllabus of the courses, the achievement of learning aims, job requirements, and understanding their educational problems.

The number of graduates was 245 in the levels of Master of Science (MSc) and PhD of biostatistics from Tehran, Iran, Shahid Beheshti, Tarbiat Modares University of Medical Sciences, and University of Social Welfare and Rehabilitation Sciences. The participants were graduated from 2011 to 2020. The data were collected by a questionnaire and analyzed using SPSS software.

Of PhD and MSc graduates, 48 (57.1%) and 70 (43.5%) participants declared, respectively, that they received the necessary theoretical and practical skills that they needed for their job. Also, clinical trial courses in both MSc and PhD periods were chosen by the graduates as the most significant courses, and one of the most applied courses in job requirements. Furthermore, statistical methods at MSc level and longitudinal data analysis at PhD level were chosen as the next important courses by the graduates, respectively.

The findings show that the syllabus meets less than half of the graduates’ job requirements, so it is not enough and is necessary to reform the contents of educational programs according to their job requirements.

Physician burnout is a serious issue associated with physician attrition, mental and physical problems, and medical errors.

This study aimed to investigate the prevalence of overall burnout among Interns-Residents and general physicians (GPs)-Specialists during the coronavirus disease 2019 (COVID-19) pandemic in Iran.

This cross-sectional study was conducted among 220 Interns-Residents and 212 GPs-Specialists in university-affiliated hospitals and clinics in Shiraz, Iran. A convenience sampling method was used to recruit the samples, and the data were gathered using Maslach Burnout Inventory that was previously validated for the Persian language. We used covariance analysis and multiple logistic regression to analyze the data.

The mean age of participants was 31.44 (ranged 21-62) years. Multiple logistic regression for GPs-Specialists showed that working in COVID-19 wards during June-July (OR = 13.93, P = 0.01, CI: 3.61-53.51) was associated with increased odds of overall burnout. Moreover, older age among GPs-Specialists was associated with decreased odds of overall burnout (OR = 0.94, P = 0.01, CI: 0.90-0.98). On the other hand, the odds of overall burnout among Interns-Residents was not significantly different between various periods (P = 0.94). Furthermore, age (OR = 0.24, P = 0.01, CI: 0.04-0.47) and being married (OR = 0.31, P = 0.02, CI: 0.12-0.81) were positively associated with decreased odds of overall burnout among Interns-Residents.

This study revealed that the risk of professional burnout among specialists and GPs increased over time during the COVID-19 pandemic. Moreover, older physicians had a lower risk of burnout. Despite the disagreements regarding the association between burnout and the duration of exposure to patients during epidemics, the findings of this study have the potential to remind policymakers of the importance of the issue among physicians during pandemics to taking appropriate action to prevent this phenomenon.

Contact tracing is a cornerstone community-based measure for augmenting public health response preparedness to epidemic diseases such as the current coronavirus disease 2019 (COVID-19). However, there is no an agreed data collection tool for the unified reporting of COVID-19 contact tracing efforts at the national level.

The purpose of this research was to determine the COVID-19 Contact Tracing Minimal Dataset (COV-CT-MDS) as a prerequisite to develop a mobile-based contact tracing system for the COVID-19 outbreak.

This study was carried out in 2020 by a combination of literature review coupled with a two-round Delphi survey. First, the probable data elements were identified using an extensive literature review in scientific databases, including PubMed, Scopus, ProQuest, Science Direct, and Web of Science (WOS). Then, the core data elements were validated using a two-round Delphi survey.

Out of 388 articles, 24 were eligible to be included in the study. By the full-text study of the included articles and after the Delphi survey, the designed COV-CT-MDS was categorized into two clinical and administrative data sections, nine data classes, and 81 data fields.

COV-CT-MDS is an efficient and valid tool that could provide a basis for collecting comprehensive and standardized data on COVID-19 contact tracing. It could also provide scientific teamwork for health care authorities, which may lead to the enhanced quality of documentation, research, and surveillance outcomes.

according to the corruption perceptions index (CPI) 2018, Iran ranked 148 among 183 countries. This position shows the crucial importance of considering corruption and its negative effect on Iran and its health care system. In this review, we aimed to shed the light on corrupt practices in Iran’s health care system and recommend some practical strategies to combat them.

This is a narrative review based on Vian’s conceptual model of corruption in the health sector to evaluate and analyze corruption in Iran’s health system. Review of the literature and documents without any time limitation were conducted in several databases including PubMed, Scopus, Web of Science, Google Scholar, and Farsi sources including Iran Medex, scientific information database (SID), and Magiran, and also the official websites of the Ministry of Health and news agencies.

Unfortunately, to the best of our review, there is less published evidence about the extent and types of corruption in Iran’s health system. Based on Vian’s model, reviewed literature revealed that Iran’s health system is prone to corruption. This system is monopolistic and self-authorized, low transparent and accountable, and required law enforcement in many areas. Evidence to clarify the situation of citizen voice was not found.

Based on this study, evidence shows corruption in financing, service provision, and resource generation of Iran’s health system. It could affect not only performance of this system but also its responsiveness and effectiveness. To combat, Iran should apply multiple strategies such as; improving good governance, strengthening legal system over the health system, reducing monopoly and discretion stepwise and manageable, enhancing community participation, and finally updating ethics codes in the health system.

Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are major public health concerns. Besides the known risk factors, other risk factors, such as vitamin D deficiency, have been suggested for NAFLD.

This cross-sectional research aimed to investigate the relationship between serum vitamin D levels and NAFLD in a group of patients with T2DM.

We investigated various clinical and biochemical parameters, including serum vitamin D level, liver function tests, and liver sonography in 1,110 adult patients with T2DM. The mean difference of numerical variables in NAFLD and non-NAFLD groups was analyzed with an independent sample t-test. Chi-square test was used to evaluate the association between two categorical variables.

Out of 1,110 patients with T2DM, 837 (75.4%) had NAFLD. The mean vitamin D level in diabetic patients with NAFLD was significantly lower than non-NAFLD group (19.71 ng/mL vs. 27.68 ng/mL, respectively; P < 0.001). Furthermore, 410 (49%) patients with NAFLD were found with vitamin D deficiency, while this value was 85 (31.1%) in non-NAFLD group. According to the results of univariate logistic regression analysis, vitamin D deficiency (OR = 3.87) and insufficient vitamin D (OR = 2.83) were the significant variables for NAFLD.

There was a significant association between vitamin D deficiency and NAFLD in patients with T2DM.

The disability to recognize emotional and mental states in others’ facial expressions is acknowledged as one of the major developmental-behavioral problems in children with autism. Therefore, it is necessary to study the effect of facial emotion recognition training on the interaction skills of children with autism.

The aim of this study was to investigate the effect of emotional facial recognition on the mother-child relationship in children with autism.

The present clinical trial was conducted based on a pre-test post-test design. Children aged 6-12 years with high- or moderate-functioning autism were assigned to two groups using the random block sampling method. Children in the intervention group were trained in 10 45-min sessions each week for 10 weeks using 40 images related to four situations of happiness, sadness, anger, and fear. The mother-child relationship questionnaire was completed one day before and one day after the intervention in both groups by the research assistant. Data were analyzed with SPSS software version 22.

Emotional state training improved the mother-child relationship in the intervention group. There was also a statistically significant difference between the total scores of the mother-child relationship in the intervention group and the control group (p <0.000).

The findings of this study suggest that teaching facial emotion recognition to children with autism can be very effective in promoting mother-child interaction and consequently, their interaction with society. Health officials can benefit from the findings of this study to improve facial recognition and consequently, the mother-child relationship.