Shiraz Emedical Journal
Volume:23 Issue: 8, Aug 2022

Iran should revise some of its current strategies and strengthen others to meet the 95-95-95 targets, focusing on active case-finding (ACF) to combat this epidemic.

This policy report aimed to shed light on the process of implementing ACF of human immunodeficiency virus (HIV) among high-risk groups on a nationwide scale.

This policy report is based on the pilot implementation of the first and second phases of optimized HIV case-finding (OCF) program. The first phase was implemented at Shiraz University of Medical Sciences, Iran, from March 2018 to September 2019, and the second phase was implemented in eight other Iranian universities of medical sciences from November 2020 to May 2021.

OCF program is being implemented successfully as a pilot in eight universities with a combined population of approximately 21 million and a diverse socio-cultural context. During the seven months of OCF program, 536 new venues of female sex workers (FSWs) or injecting drug users (IDUs) were registered, 1282 new cases received the required services, 3256 services were registered, and 2834 barcodes were activated to follow cases actively.

Evidently, OCF program requires a multi-strategy approach. The other critical issue is gaining the support and cooperation of stakeholders through a comprehensive advocacy strategy. Additionally, it is recommended to equip voluntary counseling and testing centers (VCTs) and other components of HIV surveillance systems and train their staff to ensure that their services are as efficient as possible.

Age-related macular degeneration (AMD) is the most common cause of blindness in the elderly.

Due to the increasing rate of aging and the possible role of impaired lipid metabolism as a critical pathogenic factor in AMD, this study investigated the association between serum lipid profile and AMD in the elderly of the north of Iran.

This nested case-control study (as a part of the comparative cohort of “The Amirkola Health and Ageing Project”) was performed on 77 patients with AMD and 231 healthy individuals over 60 years of age. During the ophthalmic examination, tropicamide 1% eye drops were used to dilate the pupil. Fluorescein angiography was used to diagnose AMD. Serum lipid profile components, such as triglycerides, total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL), were measured in blood samples through standard laboratory methods. All statistical analysis was performed using SPSS software (version 24).

The triglycerides mean values in AMD patients and controls were 123.32 ± 56.27 and 138.32 ± 69.58 mg/dL, respectively (P = 0.075). The cholesterol mean values were 184.75 ± 43.87 and 189.59 ± 43.52 mg/dL in AMD patients and controls, respectively (P = 0.402). The LDL mean values in AMD patients and controls were 101.42 ± 32.08 and 103.45 ± 30.83 mg/dL, respectively (P = 0.621). The HDL mean values were 48.94 ± 11.93 and 50.37 ± 12.18 mg/dL in the AMD patients and controls, respectively (P = 0.365). Additionally, there was no significant difference between the different degrees of AMD in terms of mean triglycerides, cholesterol, LDL, and HDL.

In the present study, no significant association was observed between the levels of serum lipid profile components and AMD. In addition, no significant difference was observed between different degrees of AMD in terms of serum lipid profile components.

Brain stroke is the main cause of death and disability worldwide. This disease can cause major complications in patients and place a great burden of care on caregivers. Therefore, this study was conducted to determine the effect of telenursing on the burden of care in caregivers and the rate of complications in patients with acute brain stroke discharged from neurological wards.

This two-arm parallel-group single-blind randomized clinical trial study was carried out on 72 patients with acute brain stroke discharged from neurological wards in Qom, Iran, in 2019. The patients and their caregivers were divided to control and intervention groups using random block allocation. In addition to the usual training of the ward, the intervention group received training and counseling based on their needs through phone calls for 4 weeks. However, the control group received only the usual ward training. Immediately after discharge from the hospital and 1 month later, the average care load in caregivers and urinary problems, bedsores, and the number of falls in patients were measured. A demographic questionnaire, Caregiver Burden Inventory, Braden Scale, Morse Scale, and a urinary problem checklist were used for data collection. The data were analyzed using the chi-square test, Mann-Whitney U test, independent t-test, and paired t-test by SPSS software (version 24).

After the intervention, the mean scores of the caregiver’s burden of care in the control and counseling groups were 35.22 ± 17.215 and 8.00 ± 7.556, respectively (P < 0.001). In addition, the counseling group experienced remarkably fewer urinary problems (P < 0.001) and falling (P = 0.011).

This study showed that telenursing reduced the burden of care in caregivers and decreased urinary tract infections and the number of falls in patients with acute stroke. Therefore, nurses and healthcare providers can use this program to improve the lifestyle of patients with acute brain stroke and their caregivers.

The nature of the nursing profession is one of the effective factors in the marital satisfaction of nurses.

This study aimed to examine the level of marital satisfaction in nurse couples in comparison to those whose spouse is not a nurse and also examine predicting factors of marital satisfaction.

Following a cross-sectional design, a total of 252 nurses working in educational hospitals in western and northwestern cities of Iran were recruited for this study. Participants were selected using the convenience sampling method. Data were collected using a two-part questionnaire: (1) items related to socio-demographic characteristics; and (2) items related to ENRICH Marital Satisfaction (EMS) Scale. Data were analyzed using SPSS v 21.0.

The mean (SD) age of participants was 32.4 (6.39) years. Marital satisfaction was higher among employed nurse couples, those with rotating shifts, those with a lower number of night-work shifts per month, those with personal housing, and those whose spouse was a nurse. Also, a significant association was found between income level and marital satisfaction (P = 0.002, F = 6.67).

According to the findings, nurse couples had higher marital satisfaction in comparison to those whose spouse was not a nurse. Nurses reported their marital satisfaction as moderate. Paying attention to the livelihood conditions of nurses, providing more flexibility, and giving nurses the right to choose to set a monthly work schedule can improve their marital satisfaction.

In confronting coronavirus disease 2019 (COVID-19), informing the public through social media is one of the most important strategies.

The present study aimed to assess the knowledge level of social media users about COVID-19 and its challenges in Iran.

This mixed-methods study was conducted in 2020. In the quantitative phase, the knowledge level of 299 social media users about COVID-19 was assessed in Khorramabad, Iran, using a questionnaire. Data were analyzed using the SPSS software version 23. The mean score of knowledge was measured utilizing the t-test and analysis of variance. In the qualitative phase, data collection was completed through semi-structured interviews. Purposive sampling was used, and ten faculty members and experts were interviewed. The content analysis method was used to analyze data using the MAXQDA10 software.

We observed that the mean knowledge score was 73.73 out of 100. Knowledge score had a significant relationship with educational level, field, and profession. Challenges of raising the knowledge of social media users included five themes: The nature of the disease, challenges related to users, stewardship challenges, the nature of social media, and problems related to domestic messengers.

Proper and active management of social media, along with the decisive and effective presence of health system authorities in social media, can make this platform the most important source to the public for knowledge raising during the outbreaks of communicable diseases.

For patients with end-stage renal disease (ESRD) who undergo peritoneal dialysis (PD) at home or in non-clinical centers, it is crucial to design and implement a hands-on self-care clinical decision aid system (CDAS). To this end, this descriptive work was done to determine the challenges in designing and implementing a mobile health (mHealth)-based self-care CDAS for patients undergoing PD in Iran in 2021.

This qualitative study was conducted using in-depth semi-structured interviews with 20 key informants chosen by purposeful and snowball sampling. The data were analyzed through thematic analysis to extract the challenges in designing and implementing a mHealth-based self-care CDAS.

The challenges in designing and implementing a mHealth-based self-care CDAS for patients undergoing PD in Iran were divided into six major categories, including problems with insufficient training, patients’ visits to clinical centers, prompt access to data and information, data registration/documentation, distribution of PD specialists, and data analysis within the current system.

The self-care CDAS for PD can be useful in many complicated decisions as well as when there is limited access to PD specialists. This system is efficient considering the widespread use of mobile phones, unfair geographical distribution of patients and PD specialists, and huge costs arising from visiting healthcare centers.

The benefits of addressing behavioral health issues in inpatients have been well documented. However, these problems are not frequently recognized by physicians during the hospitalization of patients in general hospitals.

This study described the current status and medical diagnoses made in psychiatric consultations to inpatients admitted to general hospitals affiliated to Babol University of Medical Sciences, North of Iran.

This cross-sectional observational research was carried out at Babol University of Medical Sciences from 2019 to 2020. All psychiatric consultations for patients hospitalized in different departments of two general hospitals affiliated to this university for 6 months were included. The mental disorders diagnosed for patients were recorded by a psychiatrist according to the diagnostic and statistical manual of mental disorders (DSM-5) criteria.

A total of 266 patients with a mean age of 51.21 ± 16.95 years were examined. Most of the consults were requested by the departments of cardiology (39.5%) and neurology (16.2%). According to the psychiatric visits, 32.3%, 51.1%, and 15.4% of the patients had no, one, and two concomitant psychiatric disorders, respectively. Mental disorders were found to have a significant association with gender (P < 0.001), admission department (P < 0.001), comorbid malignancies (P = 0.011), cardiovascular disorders (P < 0.001), need for surgical intervention (P = 0.018), a history of substance use (P = 0.001), and reasons for consult request (P < 0.001).

Mental disorders, especially mood and anxiety disorders, were identified in approximately 70% of consultations. Therefore, requesting a timely psychiatric consultation can lead to better managing hospitalized patients.

The predictive equation of the six-minute walk test designed for one population cannot reliably be used for another population. Despite introducing multiple prediction equations, there is no local such equation for our country, Iran, presently.

In this cross-sectional study, we included 116 (65 males) healthy Iranian adult subjects to measure six-minute walk distance (6MWD), define influential factors, and formulate a native predictive equation. All the studied cases aged between 20 to 50 years old. We performed 6MWT according to the guideline of American Thoracic Society.

The mean value of 6MWD was 629.98 ± 81.38 meters, (ranged 421 to 729). On average, men walked 114.29 meters more than women that was statistically significant. Moreover, 6MWD had a direct correlation with subjects’ height (r = 0.627, P < 0.001); however, it had an inverse correlation with their age (r = -0.303, P < 0.001) and weight (r = -0.218, P = 0.019). Multiple regression equation derived this formula: 6MWD = 485.25 – (99.42 × sex male = 0, female = 1) + (2.791 × height cm) – (1.614 × weight) – (1.273 × age year), which explained 61% of variability. We observed that most other countries’ predictive equations could not be reliably applied to our population.

In this study, we measured 6MWD in a healthy middle-aged Iranian population and proposed a native predictive equation, which might trigger further research and application of this simple and inexpensive test in our country.

Death due to coronary artery disease (CAD) is twice higher in men than women, and older men are more susceptible to the disease. Serum testosterone levels decrease with increasing age.

In this study, we aim to study the association between serum testosterone levels and Gensini scores in men.

This cross-sectional study was conducted on 60 men above 40 years who had undergone coronary angiography. Thirty of them had normal coronary vessels, and 30 had coronary artery disease. For each group, the Gensini score was calculated.

Serum testosterone levels in the CAD group and the control group were 4.04 ± 2.56 and 5.59 ± 2.20 ng/mL, respectively (P < 0.05), and free testosterone levels in the CAD patients and the control groups were 7.32 ± 5.24 and 12.91 ± 3.27 pg/mL respectively (P < 0.001). Sex hormone binding globulin (SHBG) levels in the CAD and the control groups were 28.88 ± 15.30 and 38.2 ± 19.9 nmol/mL, respectively (P = 0.04). Univariate analysis showed a significant association between Gensini score and total and free testosterone levels. The receiver operating characteristic curve (ROC) showed that the cut-off point of 7.97 had a sensitivity of 73.3% and specificity of 90% in predicting a high Gensini score (AUC = 0.799, P < 0.001).

Findings of our study demonstrated that serum free testosterone levels have a significant correlation with Gensini score and CAD severity.

The nature and extent of changing adherence to COVID-19 preventive health measures are different in various populations.

The aim of this study was to investigate the intention of changing adherence to COVID-19 preventive health measures (ICA-COVID-19–PHM) after implementation of the COVID-19 vaccination program compared to when they had not received the vaccine.

This cross-sectional study was conducted on 1000 participants in the 18 to 60-year-old group population (Mazandaran Province, Iran). The data were collected by an anonymous online “Google Form” questionnaire. The Pearson correlation coefficient, intra-class correlation coefficient (ICC), and paired t-test were used to evaluate the intention of changing adherence to COVID-19 preventive measures.

The correlation coefficient ranged from 0.58 for non-travel to 0.76 for personal hygiene. ICC ranged from 0.68 for non-traveling to 0.86 for personal hygiene and hand/face washing. The results of the paired t-test showed that there was a significant difference between the adherence at the present time and the intention to adhere to preventive protocols after receiving the vaccine.

The intention of changing adherence to preventive health measures, such as avoiding travel and crowded places and mask-wearing, had the most reduction.