Shiraz Emedical Journal
Volume:23 Issue: 6, Jun 2022

About one third of all new HIV infections are estimated to occur among young people globally. In recent years, the increasing age of marriage in Iran has caused increasing risky behaviors in the young population. According to evidence, risk perception toward acquiring HIV is an important factor for risky behaviors.

This study was conducted to detect the concern toward HIV acquisition among Iranian youths.
Evidence Acquisition:In this systematic review, the knowledge, attitudes, threat perception, and practices of youths toward HIV/AIDS were assessed through searching such databases as the Web of Science, PubMed, and Scopus. Quality assessment was done using STROBE and PRISMA-P checklists. A total of 1,036 articles were initially found, of which 28 articles were analyzed.

The youths’ knowledge about HIV/AIDS varied from low to moderate, their attitude was generally negative, perceived risk susceptibility was low, and risk perception ranged from 6.5 to 60%. Premarital sexual relationships were reported by 8 - 50% of the youths, while the rate of both condom use and consistent condom use was less than 50%.

The current situation is worrisome and needs serious practical measurements. Therefore, urgent and multifactorial interventions such as establishment of youths’ sexual reproductive health services and its integration into the current primary health care system across the country are needed.

Post-traumatic stress disorder (PTSD) metacognitive model is considered a model with good power. There are not enough data that this model is appropriate to combat veterans with chronic PTSD.

This study aimed to investigate the association between metacognition components, including metacognitive beliefs and attitudes, meta-worry, rumination, and cognitive-attentional syndrome (CAS), in Iranian combat veterans with PTSD.

The population of this study included all combat veterans referred to the rehabilitating center of Sari, Mazandaran province in 2016. After a clinical interview by a clinical psychologist, the veterans were divided into three groups (PTSD, non-PTSD, and non-traumatized). These three groups matched in age, gender, and socio-economic status. Exclusion criteria for three groups were as follows: Those who had a significant psychiatric disorder that has been active during the research plan. Moreover, data gathering instrument used in the current research was Metacognition Questionnaire [including Metacognitive Questionnaire (MCQ), Ruminative Responses Scale (RRS), Cognitive-Attentional Syndrome Scale (CAS-1), Impact of Event Scale-Revised (IES-R), and Meta-worry Questionnaire (MWQ)]. One-way variance analysis was used to compare groups in terms of metacognition, meta-worry, rumination, and CAS.

Consistent with the metacognitive model of PTSD, metacognition components, ruminative responses, cognitive-attentional syndrome, and meta-worry have significant differences with non-PTSD and non-traumatized. It appears that meta-cognitive components are more disruptive in PTSD patients than other control groups. This finding could be integrated into the metacognition theory.

Multiple sclerosis (MS) is among the most important central nervous system diseases and the most prevalent neurological disease in humans. It is affecting the patient's individual and social performance. Post-traumatic growth (PTG) is the experience of positive personal change due to confrontation with a crisis or traumatic event.

This study aimed to investigate the relationship of shame, guilt, and self-compassion with PTG in MS patients.

In this descriptive correlational study, the statistical population consisted of all MS patients referred to the MS Societies of Zahedan and Mashhad in 2018. Forty-six patients were selected using a convenience sampling method. Data collection tools were the Post-traumatic Growth Inventory, the State of Shame and Guilt Scale, and the Self-compassion scale. Data analyses were carried out using Pearson correlation and stepwise regression analysis.

Shame (r = -0.48, P ≤ 0.00), guilt (r = -0.44, P ≤ 0.002), and both of them (r = -0.49, P ≤ 0.001) were significantly and diversely related to PTG. Also, self-compassion had a significant positive relationship with PTG (r = 0.32, P ≤ 0.01). Stepwise regression analysis indicated that shame and guilt, when entered the equation in the first step, could determine 0.22 of the PTG variance.

It is suggested that educational classes and training workshops be held to promote self-compassion and decrease shame and guilt among MS patients.

Anal fistulas are one of the interactable cases in proctologic clinics. Managing these patients has the major risk of recurrence and incontinence.

In this retrospective cohort study, we compared the results of three sphincter saving procedures during a two-year follow-up phase.

A total of 87 patients who underwent endorectal advancement flap, cutting Seton, and pulling Seton surgeries were followed for two years from 2017 to 2018 in a tertiary proctologic referral center affiliated to Shiraz University of Medical Sciences, Iran. The recurrence rate and Wexner score were compared between the groups.

The lowest recurrence rate was 13.8% with pulling Seton technique, and the highest recurrence rate was 42.9% with endorectal advancement flap (P = 0.04). The mean Wexner score did not significantly change before and after the surgery.

According to our results, pulling Seton seems to be a safe method for treatment of anal fistulas. This technique had a low recurrence rate, and the patients’ continence was not damaged.

In recent years, the median age of marriage has increased in Iran. Premarital sex has been socially, culturally, religiously, and legally banned in Iran. Changes in sexual and social criteria, as well as communications technology, have resulted in the alteration of traditional values. Also, free time and adventure-seeking behaviors have increased unhealthy and dangerous conducts, which could lead to the prevalence of some sexually transmitted diseases (STDs). Hence, in-depth studies are required to determine the factors affecting premarital sexual relationships in young females.

This study investigated the challenges and facilitators of premarital sex among female university students in Iran.

This is a qualitative study with a content analysis approach. The participants were 24 female university students in four universities of Fars province, who were selected through purposive sampling method, followed by the snowball sampling technique. Semi-structured interviews were used for data collection, and the data were analyzed using content analysis.

The findings highlighted three main determinants of premarital sexual relationships among university students, including individual determinants, family environment, and community-related determinants.

In individual determinants, policy makers and planners should improve individual skills such as self-control, resilience to peer pressure, and the skill of saying no, along with teaching self-knowledge. To control the effect of family environment, educating parents and promoting moderate behavior with their children can be effective. To reduce social pressure, programs should be considered for young girls to express themselves and their emotions. Moreover, some new policies are needed to reduce legal restrictions for unmarried females.

Postoperative pain is a common expected problem. Appropriate medications are important to control pain, especially in breast cancer surgery with a high rate of postoperative acute and chronic pain.

This study aimed to evaluate the effect of intraoperative infusion of dexmedetomidine on acute and chronic pain after simple mastectomy.

This is a double-blind clinical trial study which included 110 eligible patients for simple mastectomy from Shahid Faghihi Educational and Medical Center in Shiraz between October 2018 and May 2019. The patients were randomized into two groups of intervention who were received intraoperative dexmedetomidine 0.4 μg/kg/h, and control group who were received the same amount of placebo (normal saline 0.9%). The severity of acute and incidence of chronic pain were assessed with VAS of pain, and brief pain inventory (BPI), and the number of analgesics (Apotel, Morphine) that patients received in first 24 hours were recorded postoperatively. Collected data were analyzed, and P-values of less than 0.05% were considered statistically significant.

Here, 110 patients (55 people in each group) were met the inclusion criteria of the study. Based on the result of this study, the mean VAS score of pain in the intervention group (0.96 ± 0.14) was significantly lower than the control group (4.44 ± 2.25) (P < 0.001). Although the incidence of chronic pain was different between the two groups after three months, this difference was not statistically significant (P = 0.871). Moreover, the number of requests and the amount of analgesia (Apotel and Morphine) in the first 24 hours after surgery in patients in the intervention group was significantly less than patients in the control group (P < 0.001). Also, the time of the first request for analgesia (Apotel, Morphine) in the patients of the intervention group was significantly longer than the control group (P-value = 0.036).

According to the finding of this study, the use of dexmedetomidine during simple mastectomy reduces pain, decreases, and delays in requirement of analgesia at the first 24 hours post-operation. However, it did not have a significant effect on chronic pain.

Anxiety is one of the most common psychological disorders in pregnancy. It seems that a pregnant mother’s anxiety has adverse effects on physical growth, motor development, and breastfeeding behavior in her baby.

This study aimed to investigate the relationship between feeding behavior and physiological parameters of neonates with antenatal maternal anxiety in cesarean section mothers.

In this cross-sectional study, with a multiple regression analysis method for each variable, 10 samples were selected based on consumptive sampling, and total 101 people were selected. Data were collected using Spielberger’s questionnaire for mothers’ anxiety before delivery, and Standard Infant Breastfeeding Assessment Tool for nutritional behavior, and physiological parameters of newborns was completed within 48 hours after delivery. Independent and dependent t-test and Pearson correlation coefficient tests were used to analyze the data using SPSS software version 16.

The mean total anxiety (state and trait) was 90.02 ± 18. 09. Pearson correlation test showed that there was no significant relationship between the two anxiety variables with the mean nutritional behavior of the neonates and the anxiety with the physiological parameters of the newborn.

There was no significant relationship between anxiety and physiological parameters and nutritional behavior of infants. Further studies with a larger sample size are recommended in the area of psychosocial support around delivery and the effect of mothers’ anxiety on the infants’ nutritional behaviors and physiological parameters.

We aimed to determine the effect of periurethral cleaning before catheterization using chlorhexidine and povidone-iodine on bacteriuria and pyuria.

This study was a single-blind clinical trial on a sample selected by convenience sampling. Demographic and clinical questionnaires were completed, and patients were randomly divided into two groups) 36 patients each of povidone-iodine and chlorhexidine using Minimization Software based on confounding variables including age, consciousness level, triage level, nutritional status, and underlying disease. The periurethral areas were cleaned with the given antiseptics and catheterized using standard and sterile procedures. Then, specimens were taken for urinalysis and urine culture immediately, 72 hours, and five days after catheterization. Then, bacteriuria rate, pyuria rate, and the number of microorganisms were determined through examinations. Data analysis was conducted using SPSS version 19.

There was no statistically significant difference in the bacteriuria rate between the two groups immediately (P = 0.76), 72 hours (P = 0.22), and five days (P = 0.50) after catheterization. The positive pyuria rate was not significantly different between the two groups immediately after catheterization. However, it was significantly higher in the povidone-iodine group 72 hours (P = 0.03) and five days (P = 0.004) after catheterization. The Mann-Whitney test compared the mean number of microorganisms between the two groups at different times. This test showed no significant difference in the number of microorganisms immediately (P = 0.93), 72 hours (P = 0.43), and five days (P = 0.61) after catheterization.

Due to the lower side effects of chlorhexidine than povidone-iodine, it is suggested that similar studies be performed in other hospital wards with more stable patients to obtain more statistically significant results.

Today, the COVID-19 pandemic is ever-increasingly challenging healthcare systems globally with many uncertainties and ambiguities regarding disease behavior and outcome prediction. Thus, machine learning (ML) algorithms could be potentially demanding to tackle these challenges.

The present study aimed to construct and compare two prediction models based on statistical and computational ML algorithms to predict mortality in COVID-19 hospitalized patients and, finally, adopt the best-performing algorithm, accordingly.

Having considered a single-center registry, we scrutinized 482 records of laboratory-confirmed COVID-19 hospitalized patients admitted from February 9, 2020, to December 20, 2020. The most important clinical parameters for COVID-19 mortality prediction were identified using the Phi coefficient technique. In the next step, two statistical and computational ML models, ie, logistic regression (LR) and artificial neural network (ANN), were evaluated through the metrics derived from the confusion matrix.

Predictive models were trained using 16 validated features. The results indicated that the best performance pertained to the ANN classifier with a positive predictive value (PPV) of 0.96, a negative predictive value (NPV) of 0.86, the sensitivity of 0.94, specificity of 0.94, and accuracy of 0.93.

According to the results, ANN predicted mortality in hospitalized patients with COVID-19 with an acceptable level of accuracy. Therefore, it would be extremely reasonable to develop intelligent decision support systems to early detect high-risk patients, helping clinicians come up with proper interventions.

Phone interview is a safe way for collecting sensitive data due to no need for direct contact with the interviewees and their privacy.

The purpose of this study was to investigate the feasibility and validity of phone interviewing using mobile phones to collect sensitive information related to the participants’ sexual behavior.

This cross-sectional study was conducted on the sexually active population of Marvdasht, Iran, from 2017 - 2018.

A total of 5,894 individuals (2,991 from urban and 2,903 from rural areas) from both genders (n = 3,202 males vs. n = 2,692 females) with an age range of 18 - 50 years were included in this study. The participation rate was convincing (92.18%), and the response rate to all questions was also very high (99.1%). According to the results, gender and place of residency had statistically significant associations with the rates of participation and response.

The results suggested that a phone interview is a potentially useful method for gathering sensitive information in Iranian population, a community with a religious background.