Journal of Kerman University of Medical Sciences
Volume:29 Issue: 5, Sep-Oct 2022

The present study was designed to determine the prevalence of Toxoplasma gondii seronegative pregnant women, estimate the frequency of fetuses at risk of congenital toxoplasmosis in the study area, and also to investigate the awareness of the studied mothers about T. gondii disease. A total of 740 pregnant women referred to two health centers in Qazvin province were surveyed voluntarily for anti-T. gondii IgG and IgM antibodies by enzyme-linked immunosorbent assay (ELISA). IgG avidity test was used as a confirmatory test for samples showing positive or borderline results for IgM antibodies. Data on socioeconomic, demographic, and knowledge of participants about toxoplasmosis were collected using questionnaires and through face-to-face interviews. Multivariable logistic regression modeling was used to identify the potential predictor variables for T. gondii infection.  Overall, 21.2% (157/740) and 0.27% (2/740) of pregnant women were positive for T. gondii IgG and IgM antibodies, respectively. Only 1.7% (13/740) of expectant mothers had prior information on toxoplasmosis. Among socioeconomic and demographic variables, contact with soil was the merely cause of a significant association with T. gondii infection. Other variables including age, occupation, education level, residential area, source of drinking water, abortion history, number of childbirth, consumption of raw/undercooked meat, having home cat and and consumption of raw vegetables failed to establish significant associations.  Our results clarified that the prevalence of T. gondii has remarkably reduced in the study area. This finding indicates a low risk of congenital toxoplasmosis in this region.

In our previous studies, the effect of sex hormones on brain edema reduction after traumatic brain injury (TBI) was demonstrated. In the current study, alone and combined effects of 17-β estradiol (E2) and vitamin D (Vit D) on TBI in male rats were investigated. Male rats were divided into six groups, including sham, TBI, vehicle, E2, Vit D, and E2+Vit D. In all groups except sham, moderate-intensity diffuse TBI was induced by the Marmarou’s method. Vehicle, E2, Vit D and their combination were intramusculary injected one and 12 hours after the TBI. The brain water content, permeability of blood brain barrier (BBB) and histopathological outcome were assessed 24h after TBI. The neurological outcome score was determined using the veterinary coma scale (VCS). Significant reductions in brain water content (P<0.001, P<0.05 and P<0.01, respectively) and BBB permeability (P<0.001) appeared in the treated groups with E2, Vit D, and E2+Vit D compared to the vehicle group. Twenty-four hours after the injury, the neurological scores in the E2, Vit D, and E2+Vit D groups increased significantly compared to the vehicle group (P<0.05). Dramatic improvement in histopathological outcome was also observed in the treated groups compared to the vehicle group. Alone and combined consumption of estrogen and vitamin D may similarly decrease the development of brain edema and improve the neurological and histopathological consequences of TBI. Therefore, consumption of vitamin D did not enhance the neuroprotective effect of estrogen in TBI.

Support for evolutionary care of twin or multiple birth infants whose populations are rapidly growing is of considerable interest. Co-bedding has been considered as one of the evolutionary care strategies being implemented in many neonatal intensive care units (NICUs) throughout the world. This study is designed to investigate the effect of co-bedding among premature twin or multiple birth infants on their growth and physiological stability in a NICU with the largest number of births in Iran. It is a randomized clinical trial performed on 80 pairs of premature twin infants hospitalized in the NICU of Shahid AkbarAbadi Hospital in Tehran, Iran. Patients were randomly allocated into the two groups; co-bedded and routine care. Data were collected through a demographic questionnaire and a co-bedding checklist and compared between the two groups. Data analysis showed that the weight gain and mean of NICU hospitalization days in the co-bedded group were significantly different from those of the standard care infants (P<0.001). However, there was no significant difference in terms of increase in height (P=0.1), head circumference (P=0.4), heart rate (P=0.3), arterial oxygen saturation (P=0.12), and respiratory rate (P=0.68) between the two groups. On the basis of results, co-bedding could lead to better weight gain in twin birth infants and consequently accelerate their recovery and discharge.

This study examined the effect of prenatal and early postnatal ethanol exposure on the structural, functional, and molecular alterations of rat’s offspring kidney on postnatal days 21 and 90. Pregnant rats on gestation day 7 were divided into the two groups, namely control and ethanol groups. Rats in the ethanol group received ethanol (4.5 g/kg B.W) from gestation day 7 throughout lactation. Nephrin, podocin, vascular endothelial growth factor receptors (VEGFRs) 1 and 2 gene expression were measured by RT-PCR technique. The MMP2 and MMP9 levels in the kidney tissue and plasma cystatin C level were measured by ELISA method. The results revealed a significant alteration in mRNA expression of nephrin, podocin, and VEGFR, as well as MMPs amounts in the kidneys of the offspring. Cystatin C level, the ratio of cystatin C/serum creatinine, serum creatinine, and urine urea showed a significant increase, but urine creatinine and GFR showed a significant decrease in the offsprings of the ethanol group compared to the control group. Histopathological changes such as fibrosis, kidney cells proliferation, leukocytes infiltration, and vacuolization have also seen in the kidney of the offsprings after 21 and 90 days from birth. Taken together, these results provide evidence that pre and early postnatal ethanol exposure renal toxicity is in part associated with alteration of nephrin, podocin, and VEGFRs genes expression, as well as MMPs amount changes. Furthermore, it was found that these molecular alterations were triggered by inflammatory reactions manifested by fibrosis, proliferation, and polymorphonuclear(PMN) leukocytes infiltration.

T Exposure of normal subjects to dust storm (DS) with different doses of ambient air-born dusty particulate matter (PM) causes memory and locomotion impairment, anxiety and depression-like behaviors. This study was designed to investigate the effect of sub-chronic exposure to DS with inhalation of ambient PM in a designed special chamber on cognition, anxiety, depression, locomotion behaviors, brain tissue inflammatory cytokines and antioxidant indices in healthy adult rats. Adult male Wistar rats (250-300 g) were divided randomly into the 4 groups: Sham (clean air, contains the least dusty PM < 150 μg/m3), DS1 (200-500 μg/m3 PM), DS2 (500-2000 μg/m3 PM) and DS3 (2000- 8000 μg/m3 PM). Rats were exposed to the clean air or different sizes and concentrations of PM in DS during the first 4 consecutive days of each week in an experimental actual-ambient dust exposure chamber. Sub-chronic exposing to dust storm PM impaired avoidance memory and locomotion, increased anxiety and depression like behaviors. These disturbances were in line with increased levels of inflammatory cytokines in brain tissue and suppressing the antioxidant indexes. Current findings indicated that exposure to ambient PM due to DS caused cognitive, anxiety, depression-like and locomotion behaviors impairment by increasing the neuroinflammatory responses and suppressing the antioxidant indexes in the brain.

Molar incisor hypomineralization (MIH) is a developmental enamel defect of the incisor and molars that can lead to fear of dentistry in children. This study aimed to compare the dental fear of children aged 8 to 12 years with MIH and children with permanent first molars without hypoplasia in 2020 in Isfahan, Iran. In this descriptive-analytical cross-sectional study, the participants included 200 students aged 8-12 years old in Isfahan, who were randomly selected from the second to sixth- grade students referred to the clinics. The examination was performed by a dentistry intern using a disposable dental mirror and dental probe on the unit. Fifty-two children with MIH and 148 children with permanent first molars without hypoplasia were enrolled. The Dental Subscale of the Children’s Fear Survey Schedule (CFSS-DS) questionnaire was used to collect information, which includes two sections: demographic information and 15 questions on different areas of fear of dental treatment in children. Data were analysed through SPSS 20 software and using descriptive-statistical tests (frequency and percentage, mean), t test, chi-square test, and logistic regression test. P < 0.05 was defined as a statistically significant level. The mean score of dental fear was 15 ± 35 (ranged from 15 to 75) which indicated moderate level of dental fear in the participating children. In whole, 62.5% of children were afraid of dentistry. The rate of dental fear in girls was 9 times higher than in boys (P < 0.05). Also, the rate of dental fear in children with MIH was 46 times higher than in children who did not have this disorder (P < 0.05). The frequency of dental fear in children with severe disorders was significantly higher than in children with mild defects (P = 0.000). There was no statistically significant difference in terms of dental fear among different age groups (P = 0.313). Also, with increasing the number of dental visits, dental fear increased by 1.2 times (P < 0.05), which was statistically significant. Fear of dentistry in children with MIH was significantly higher than in children with molar teeth without hypoplasia.

Cancer as a chronic and severe disease, causes a lot of psychological distress in patients. One of the psychological interventions to control distress is metacognitive therapy. The aim of this study was to evaluate this type of treatment on life expectancy and consequently adherence to the treatment of the patients. This study was a quasi-experimental two-group study. A total of 70 patients with gestational cancer were selected by convenience sampling and randomly divided into the intervention (n = 35) and control (n = 35) groups. The intervention group received 5 sessions (45-60 min) of metacognitive therapy, but the control group received the routine intervention. Data were collected using three questionnaires including: demographic and disease data questionnaire, Madanloo Treatment Adherence Questionnaire and Snyder’s Hope Scale. Metacognitive therapy made significant changes in life expectancy and adherence to treatment in the intervention group compared to the control group (P < 0.0001). The results of an adjusted analysis of covariance to compare the scores of treatment adherence and life expectancy after the intervention in the intervention group were 15.55 and 19.6 higher on average, respectively. The study indicates that metacognitive therapy has been effective in improving life expectancy and adherence to treatment of patients with gastrointestinal cancer. This intervention can be considered as an effective psychological intervention for these patients. Therefore, it is suggested that this intervention be established and promoted in counseling and psychotherapy centers in hospitals and treatment centers to accelerate the recovery process of these patients.

Inadequate health literacy (HL) in dialysis patients increases the risk of poor self-care and decreases severe self-care and severe negative health outcomes in these patients. This study aimed to investigate HL and its related factors in dialysis patients in Kerman, Iran, in 2021.

This cross-sectional study was performed on 280 dialysis patients who referred to Kerman (Iran) dialysis centres. The participants were selected through multi-stage sampling method. The study was conducted using the Iranian Health Literacy Questionnaire (IHLQ). The higher score shows a better HL.

The mean age of the subjects was 57.75 ± 13.87 years. The mean score of HL was 9.12 ± 4.54 out of 20 points. During multivariate regression, there was a significant relationship between HL and age (β = -0.08, P = 0.02) and level of education (elementary/literacy (β = 4.607, P < 0.001), middle school (β = 6.38, P < 0.001), high school (β = 8.573, P < 0.001) and academic education (β = 9.410, P < 0.001), and there was a significant relationship between HL and eye disease (β = -0.903, P = 0.001).

Most participants did not have adequate HL, while HL as the most important determinant of self-care can improve patients’ quality of life and reduce their health care costs. Therefore, in order to increase self-care, planning and necessary interventions, the HL of these patients seems to be necessary

This meta-analysis study aimed to evaluate post-traumatic growth (PTG) in cancer patients.

We systematically searched for studies that reported PTG in cancer patients. Then, irrelevant studies were removed after the abstracts of articles were studied, and articles completely related to the research purpose were selected by examining the full texts of the articles. Finally, the articles that met the inclusion criteria were selected for analysis based on the criteria of critical evaluation.

Of 21 articles, nine studies were performed on women, one study on men, and 11 studies on both sexes, and all of them used post-traumatic growth inventory (PTGI). The studies showed that the mean PTGI score was 60.72 and heterogeneity was not statistically significant (I2 = 0.0, heterogeneity = 0.998). The subgroups classified according to continents showed that the mean PTGI scores in Asia, Europe, and the United States were 61.40, 59.12, and 60.42, respectively.

Recognition of the psychological responses in cancer patients requires much more attention from health care professionals, and they should consider programs to enhance PTG in cancer survivors.

Telepsychiatry is a type of mental health service delivery using information and communication technology for patients living far from psychiatrists It can reduce the number of travelers looking for mental health services. This study aimed to review articles that reported the percentage of prevented travels or referrals using telepsychiatry.

The PubMed database was searched in September 2019 for this review study. Data were extracted from admitted studies based on a series of variables consisting of author, country, modality, referral setting, urgency, study design, sample size, and percentage of prevented travel. Descriptive statistics were used to analyze data.

Eight studies were included. Half of these studies were conducted in Australia. Real-time telepsychiatry modality was used in most of the studies (75%). The hospital was the most referral setting in the studies (62.5%). The type of telepsychiatry services delivered in 75% of the studies was elective. The study design of 62.5% of studies was prospective. The number of included participants in the studies ranged from 28 to 1943. The percentage of avoided travels ranged from 12 to 79.

Successful telepsychiatry systems could prevent unnecessary referrals and travels. However, the effective use of telepsychiatry services depends on various factors, including the type and period of the disease, the therapist’s efficacy in terms of correct diagnosis and treatment, and patient cooperation.