Shiraz Emedical Journal
Volume:23 Issue: 9, Sep 2022

The psychosocial risks and job stress have been considered as the most important factors affecting the occupational health and safety and, therefore, exerting significant impact on the health conditions of individuals, organizations, and national economy.

The present study investigated the experiences of the nurses working in COVID-19 wards of specialty hospitals in Shiraz, Iran.

Semi-structured interviews were carried out via telephone. A total of 15 participants (11 nurses and 4 active supervisors of COVID-19 wards) were included in the study. A conventional content analysis was applied.

COVID-19 ward nurses had a perception of differentiation because they had experienced difficult conditions and had higher social responsibilities. However, they managed to retain their social responsibilities despite suffering from anxiety and fear, physical and mental pressures, as well as various deficiencies. Four themes including fear and anxiety, burnout, deficiencies, and expectations were explored in this study.

Overall, COVID-19 pandemic was found to have posed several challenges for nurses as the front-line staff in Iran. Therefore, it was recommended that necessary measures and strategies should be adopted in order to address these challenges.

The prevalence of anxiety and depression is high in rheumatoid arthritis (RA) patients. As RA patients tend to be immunodeficient, they are at greater risk of coronavirus disease 2019 (COVID-19) infection due to their scheduled hospital appointments. Therefore, they have become more anxious and worried during COVID-19 pandemic, and some patients recently have canceled or postponed their treatment.

This study aimed to assess the effect of stress, anxiety, and depression due to COVID-19 outbreak on non-compliance to treatment among RA patients.

In this cross-sectional study, we included 149 RA patients (male/female = 12: 137). Four questionnaires, including the 21-item Depression, Anxiety, and Stress Scale (DASS-21), 14-item Perceived Stress Scale (PSS-14), 18-item Health Anxiety Inventory (HAI-18), and 8-item Morisky Medication Adherence Scale (MMAS-8) were employed. The questionnaires were filled by the researchers on behalf of the participants using telephone interviews due to social distancing protocol.

There was a significant negative correlation between stress (P = 0.001), anxiety (P < 0.001), health anxiety (P = 0.014), and depression (P = 0.001) and compliance to treatment among RA patients. However, anxiety was the only predictor for non-compliance to treatment.

Therapists should be aware of the symptoms of stress, anxiety, and depression among their RA patients, especially during stressful life events, and carefully monitor their compliance to treatment to prevent exacerbation of RA.

Coding errors lead to incorrect classification of diseases and thus severely affect health care planning and epidemiological research.

This study aimed to investigate the factors affecting clinical coding errors.

This descriptive study was conducted in 2020 in 2 stages. In the first stage, a questionnaire was developed by examining relevant resources, documents, and articles. The questionnaire’s validity was examined by 5 health information management experts. Its reliability was determined using Cronbach α and correlation coefficient (r = 0.84%). In the second stage, the data were collected by visiting teaching hospitals affiliated with Shahid Beheshti University of Medical Sciences, examining the medical records, and interviewing the coders. Data were analyzed using descriptive statistics.

Non-observance of diagnostic principles by physicians, illegibility of medical records, use of ambiguous and nonstandard abbreviations, and incomplete medical documentation were the most important causes of coding errors.

Considering the importance of coding in presenting correct data as a powerful lever in health care, knowledge of the factors affecting the occurrence of coding errors will greatly contribute to the selection of effective strategies to reduce and eliminate errors.

The coronavirus disease 2019 (COVID-19) crisis has greatly impressed medical education by shifting traditional educational methods to e-learning.

This study evaluated the undergraduate medical students' attitudes toward e-learning during the COVID-19 pandemic

This cross-sectional study included undergraduate medical students of Mashhad University of Medical Sciences, Mashhad, Iran, in the academic year 2020 - 21 by census sampling method, whose attitude toward e-learning was evaluated based on the Ghanizadeh et al. scale. Categorical variables were demonstrated with frequency and percentage, and quantitative variables were described using the mean and standard deviation. An independent-sample t test was run to study the hypothesis. Analysis of covariance (ANCOVA) was performed to compare pre-clinical and clinical groups' attitudes toward e-learning after gender control. Statistical analyses were performed by SPSS 23.

The study enrolled 528 undergraduate medical students. The findings indicated that 85.4% of the students agreed with the necessity of more effective e-learning in medical education, and 95.5% believed that e-learning should play a complementary role in medical education. It was found that clinical students had a marginally statistically significantly better attitude toward e-learning than pre-clinical students (t = -2.04, df = 526, P = 0.041). Nevertheless, no significant difference was observed between the two groups after gender control (t = 2.87, P = 0.091). It was shown that males had more positive attitudes toward e-learning than females (t = 2.28, df = 526, P = 0.023).

The results revealed acceptable attitudes toward e-learning. Although many students declared e-learning's usefulness and confirmed its complementary role in medical education, some announced that it could not replace in-person training.

Hepatitis C virus (HCV) is the main cause of acute and chronic liver failure. It seems that interleukin-38 (IL-38), a member of IL-1 cytokine family, has an anti-inflammatory function through binding to the receptor of several cytokines.

To examine serum level of IL-38 in HCV-infected patients and its correlation with liver enzymes.

We measured serum levels of IL-38 and liver enzymes in 26 untreated and 11 treated HCV-infected patients and 26 healthy individuals using ELISA and biochemistry assay kits, respectively.

Serum level of IL-38 was significantly lower in untreated HCV+ patients compared to treated patients (P = 0.014) and control group (P < 0.0001). In addition, IL-38 levels negatively correlated with alkaline phosphatase (ALP) levels in untreated HCV+ patients (r = -0.905, P = 0.042). However, no significant correlations were detected between serum levels of IL-38 and other liver enzymes.

Our results suggest a potential anti-inflammatory role for IL-38 in chronic HCV infection which can be implemented to prevent severe hepatic failure in patients with hepatitis C.

Information literacy is a capability that enables individuals to create, sustain, and deepen communication with others, which can be effective in many organizational dimensions such as organizational ethics and career development.

This study aimed to determine the relationship of information literacy and professional ethics with career development among Zahedan University of Medical Sciences (ZAUMS) staff.

Using systematic sampling, this cross-sectional study was conducted on 238 ZAUMS staff in southeast Iran in 2018. Data were collected through individual interviews using standard questionnaires Information Literacy, Professional Ethics, and Career Development. The data were analyzed using SPSS-v21 software and descriptive statistics, one-way ANOVA, and t-test.

Of 237 individuals, 116 (48.7%) were males with a mean age of 38 years. The information literacy and career development scores were in the moderate range (means of 170 and 56, respectively), while the professional ethics score of the majority was poor, with a mean of 32. There was a significant direct relationship between information literacy (coefficient = 0.189) and professional ethics (coefficient = 0.391) with career development (P < 0.05). Multivariate linear regression showed that an increased level of employees' access to information had significant positive effects on career development (β = 0.878, P < 0.01). Also, an increase in the level of career development (performance evaluation, workplace environment, supervision status, and educational factors) and professional ethics (loyalty and respect to others) was associated with increased levels of information literacy (P < 0.05).

Information literacy and professional ethics could increase career development. Therefore, it could improve organizational productivity. It is suggested that professional ethics workshops and courses be held to improve staff's information literacy.

SARS-CoV-2 is a novel virus that caused the recent global pandemic. Health care workers (HCWs), especially hospital staff, are at a higher risk of infection by this virus than the general population. In this study, anti-SARS-CoV-2 IgG antibodies were assessed in hospital workers.

This prospective seroconversion-based cohort study assessed chronic immunity against covid-19 in the staff of two hospitals, the main referral hospital and a general hospital in Shiraz, south of Iran. A valid and reliable checklist was filled out for each available staff member willing to participate in this study through a face-to-face interview. Furthermore, the titer of anti-covid-19 IgG was measured by ELISA twice; in July 2020 after the second wave of COVID-19 and in February 2021 after the third wave in IRAN.

One hundred forty (65%) of the 214 members who participated in both stages of this consideration were from the COVID-19 referral healing center, and 74 (35%) were from the common clinic. Twelve (5.6%) of staff members had anti-SARS-CoV-2 IgG antibodies, including 10 (7.1%) from the referral healing center and 2 (2.7%) from the common healing center (P = 0.23). In the second measurement (second overview), 79 (36.9%) of members had IgG antibodies; 58 (41.4%) from the primary hospital and 21 (28.3%) from the second healing center (P = 0.039). Cruel of the IgG titer within the first study and the referral clinic was 0.8 ± 0.3 compared to 0.15 ± 0.42 within the common clinic (P = 0.001). These figures were 3.05 ± 4.58 and 1.74 ± 3.53 in both clinics and within the second overview separately (P = 0.003). IgG levels were significantly higher in the second overview compared to the first (P < 0.0001).

During the third wave of COVID-19, a significant proportion of hospital staff developed COVID-19 IgG, especially in the referral hospitals for COVID-19. As a result of their higher and chronic exposure to COVID-19 patients than the general hospital staff, the titer of IgG in the referral hospital staff was also higher. However, the seroconversion rate between the two waves was 1.8 times in the general hospital staff compared to the referral hospital, possibly due to less conservative precautions against covid-19 among them. Even after receiving the anti-covid-19 vaccination, it is important to monitor the immunity of hospital staff to covid-19 and to adhere strictly to standard precautions.

Adipocytokines secreted by adipose tissue are suggested to play a significant role in developing obesity-related complications. On the other hand, regular high-intensity interval training (HIIT) has been shown to reduce the risk of metabolic complications in obese subjects.

The effect of HIIT was evaluated on serum and adipose tissues (inguinal and retroperitoneal) adiponectin and TNF-α levels in rats fed with a high-fat diet plus sucrose solution (HFDS).

Thirty-two male Wistar rats were randomly divided into HFDS and standard diet (SD) groups. After 12 weeks, each group was divided into a sedentary group and a HIIT group. An HIIT program was performed three times/week for eight weeks. Inguinal and retroperitoneal adipose tissues and serum were collected to assay adiponectin and TNF-α levels. Also, serum glucose and insulin levels, insulin resistance index (HOMA-IR) were measured.

HFDS significantly increased weight gain, weight of inguinal (P = 0.001) and retroperitoneal fat depots (P < 0.001), and HOMA-IR (P < 0.001) but reduced serum TNF-α levels (P = 0.011). HIIT was able to decrease weight gain and fat mass (P < 0.05) but did not affect inguinal and retroperitoneal fat depots’ adipokines (adiponectin and TNF-α) levels and HOMA-IR (P > 0.05).

HIIT program can have significant reducing effects on weight gain and fat weights, but it does not effect on circulating and fat depots' adiponectin and TNF-α levels in rats fed a HFDS.

The reduction of preventable deaths from non-communicable diseases, including cancers, is one of the main targets of universal health coverage. Not only there is a shortage of financial resources for universal health coverage for cancer patients in many countries, but also there are many challenges in the continuity and the quality of care. There are disparities rooted in both providers’ and patients’ behavior at the time of care. Unmet needs for information on treatment and prognosis, inadequate cost coverage of care, and inadequate support for other living costs are contributing factors to poor prognosis in cancer patients, especially in cases with advanced stages and those living in low-income countries. There is a need for a comprehensive, holistic approach to the care of cancer patients considering the patients’ socioeconomic and cultural status and the institutional status of the providers.

Aneurysm formation of internal carotid arteries (ICA) in patients with mucormycosis is a scarce phenomenon. However, the prevalence of rhino-cerebral mucormycosis has been reported to increase after the Coronavirus disease 2019 (COVID-19) pandemic.

Three patients with stroke and subarachnoid hemorrhage presented due to ICA aneurysm after the involvement of adjacent paranasal sinuses (PNS) with mucormycosis. They had a history of diabetes and corticosteroid use. Also, one of them was treated with imatinib. Two out of the three patients were infected with SARS-CoV-2 before developing mucormycosis. Two patients had diagnostic angiography before endovascular intervention. One patient did not undergo any therapeutic intervention due to total artery occlusion, whereas the other patient experienced a successful parent artery occlusion by coiling and only survived this patient. Although all patients received antifungal treatment and surgical debridement, two of them died.

In patients with rhino-cerebral mucormycosis, aneurysm evolution should be promptly and meticulously investigated by Magnetic Resonance Angiography (MRA) and Computed Tomography Angiography (CTA). As this type of aneurysm is very fast-growing, as soon as the involvement of the sphenoid sinus is detected, the possibility of ICA aneurysm formation should always be kept in mind. If the patient develops an aneurysm, prompt intensive antifungal therapy and therapeutic endovascular interventions such as stenting, coiling, or sacrificing should be considered as soon as possible to optimize outcomes.